The practical nurse in today's setting or the practical solution.
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Humans↗
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Family nursing education and family nursing practice in Nigeria.
A survey of six Nigerian nursing program curricula was conducted to determine the extent to which family nursing theory was used as a reference for conceptualizing nursing care in Nigeria. In addition, 25 nurse clinicians were purposely selected from three levels of primary, secondary, and tertiary health care units in Ile-Ife, Nigeria, and were interviewed to determine the extent to which nurses in practice reported using family assessment tools in their practice. The survey of the postgraduate curricula showed that master's and doctorally prepared nurses specializing in community health nursing have a theoretical base in family nursing theory. The limited focus on family nursing theory in basic, postbasic, and first-degree nursing curricula was deemed inadequate to develop the knowledge and skills necessary for all practicing nurses to embrace family-focused care in Nigeria. In nursing practice, families were seen to be involved in nursing care only to the extent of meeting financial and physical care needs of their family members. Findings from this study point to the need for a reorientation of the nursing curricula in Nigeria to include more family nursing theory. Specialized education of family nurse practitioners who would function at all levels of care also is a desirable goal to provide holistic health care to Nigerian families.
Attitude of Health Personnel↗
[Are clients' well-being and everyday life starting points in nursing practice?].
In this paper the goal of nursing and nursing care are explored from the point of view of clients and nurses. The basis of this text is on PhD, dissertation Health, wellbeing and nursing as experienced by municipal residents and nurses (see Astedt-Kurki 1992b). The aim of that study was to gain more information on people's individual health and of the possibilities of nurses working in Finnish primary health care have in supporting their clients. The experiences of health as results of the study reveal individual meanings. Clients' expressions of health contain different kinds of values of good life, eg. peace, freedom, religiousness, humour, human relations etc. Everyday-life experiences of health in this study are feelings of health, knowledge about one's state of health and action, eg. personal self-care. There are differences in views of health and nursing between clients and nurses. It seems that nurses view clients' health also in a disease-oriented manner although there are efforts to client-centered nursing. Nurses did not describe eg. religiousness as a part of clients' health and wellbeing. Another example of the differences between conceptions of nurses and clients is health education, which mostly in nursing care is based on general knowledge of health as opposite of disease without taking into consideration the client's personal life and situation. If the basic interest of nursing practice is eliminating diseases, nursing care is usually carried out by performing different tasks on clients. Part of the nursing care is client-oriented nursing. Awareness of the significance of health and wellbeing in human life helps nurses taking care of their clients individually.
Attitude to Health↗
Evaluation of the Penn Macy initiative to advance academic nursing practice.
In the realm of academic practice, schools of nursing, especially those in research-intensive environments, face a dilemma. These schools are in the best position to shape nursing science through research based in academic practice. Yet they also face formidable challenges to maintaining balance among the three legs of the tripartite mission. The questions of whether and how to commit resources to move forward their academic practice agendas are not answered easily. The Penn Macy Initiative to Advance Academic Nursing Practice aimed to assist such schools in their development of academic practices through a week-long intensive institute and 1 year of consultation and follow-up. An evaluation of the outcomes of that experience for 21 participant schools together with the baseline characteristics that appeared, retrospectively, to be associated with success are presented and discussed.
Education, Nursing, Graduate↗
The impact of Internet access on nursing practice.
Currently, according to Richards (2001), nurses are unsophisticated in informatics potential. The majority of practicing nurses are limited in their exposure to and competence with computer technology. Richards stated. "Such a deficiency is juxtaposed against the fact that young nurses entering the profession have grown up surrounded by technology, assimilating it as easily as the air they breathe" (p. 6). The new generation of nurses can greatly influence the art and science of nursing during this massive communications revolution. These "Net nurses" will view technology in the same light as contemporary nurses do their stethoscopes, creating a nursing culture that embraces technology and advances the profession in ways that Florence Nightingale could never have imagined.
Computer User Training↗
A comparison of students in practical nursing programs and students in associate degree nursing programs.
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Education, Nursing, Associate↗
[Note from the health administration on shared responsibility and course of action for practical nurses' collaboration in administration of drugs].
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Denmark↗
The implementation of theory-based nursing practice: laying the groundwork for total quality management within a nursing department.
Total Quality Management (TQM) is a management philosophy that has had great success in increasing quality and productivity in the private sector. Health care executives are interested in adapting this approach to a health care environment. This article discusses the implementation of theory based nursing practice as one initiative that lays the groundwork for the successful utilization of TQM in a nursing department. The barriers to quality are usually processes not people. Implementation of Jean Watson's nursing theory emphasizes that nurses are co-participants in the processes of health care which results in better outcomes. Nurses are viewed as knowledge workers. Treating them as such, removes barriers to pride of workmanship and renews their commitment to the pursuit of excellence in their care.
Aged↗
An ethical nursing practice model.
Providing a framework within which nurses may practice is a challenge for nursing executives. The national emphasis on ethical issues and decision making provides a compelling argument for incorporating such concepts into practice models. The author discusses a nursing practice model based on five ethical principles that are applied to all aspects of nursing practice.
Beneficence↗
Smoking cessation interventions in nursing practice.
Smoking cessation treatment by nurses in clinical practice significantly increases the number of smokers who are able to successfully quit the behavior. Nurse-managed cessation interventions have been shown to be effective with smokers, yet many nurses lack the knowledge to identify smokers easily, to identify those treatments that are most efficacious, and to deliver appropriate interventions. This article highlights recent developments in smoking cessation treatment that can be integrated into nursing practice. Attention is given to cessation techniques in special populations, including youth.
Female↗
Advanced practice issues: results of the ONS Advanced Practice Nursing survey.
PURPOSE/OBJECTIVES: To ascertain the critical issues in current advanced practice nurse (APN) roles in oncology. DESIGN: Descriptive. SETTING: National. SAMPLE: 368 Oncology Nursing Society (ONS) APNs in oncology practice. METHODS: Subjects completed an 11-page self-administered questionnaire comprised of 62 multiple-choice and open-ended questions. Subjects were asked to identify level of importance for ONS to address selected issues in each section. MAIN RESEARCH VARIABLES: Demographic information and APN issues regarding practice, outcomes, prescriptive authority, reimbursement, education, continuing education, licensure and certification, legislation, and challenges facing oncology APNs. FINDINGS: The majority of APNs were nurse practitioners working in a hematology/oncology practice in an urban setting providing direct patient care. Priority practice issues were lack of agreement among state boards of nursing related to privileges, lack of understanding of the role by patients and healthcare professionals, and lack of an APN definition. Important APN outcomes were symptom management, quality of life, patient/family satisfaction, and cost of care. Priority educational topics were oncology disease management, pharmacology, advanced physical assessment, and reimbursement. Challenges facing oncology APNs were lack of an APN definition, reimbursement issues, documentation of outcomes, prescriptive authority, variance in education, merging of current roles, certification, loss of cancer specialty, and second licensure. CONCLUSIONS: Numerous APN issues continue to be unresolved. APN outcomes research is needed to validate the oncology APN role in cancer care. IMPLICATIONS FOR NURSING PRACTICE: Survey results and specific recommendations have been forwarded to the ONS Steering Council and Board of Directors for implementation decisions.
Attitude of Health Personnel↗
Advanced practice nursing role: clinical nurse specialist.
The public continues to demand quality health care that focuses on the achievement of quality patient outcomes. The clinical nurse specialist is an advanced practice role that originated in the early 1900s as a result of similar public demand, and continues to evolve to meet quality health care needs. Advanced practice nurses have many opportunities to create expanded nursing roles. Orthopaedic nurses also continue to refine their practice roles, and the clinical nurse specialist is one such example.
Clinical Competence↗
Working toward the future of pediatric advanced practice nursing.
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Forecasting↗
Analysis of a decade of critical care nursing practice research: 1979 to 1988.
The purpose of this study was to analyze critical care nursing practice research published in leading refereed nursing research journals during the period from 1979 to 1988 to identify knowledge-building methods and research outcomes in critical care nursing. Findings indicate a significant increase in the number of nursing practice research studies published as well as a high percentage of intervention-oriented studies. The results of the study reflect the interest that critical care nurses have in identifying a research-based practice.
Clinical Nursing Research↗
Redesigning nursing practice. The partners in patient care model.
Several nursing practice models use nurse extenders/partners to extend nurses' time. The authors discuss the development, implementation, and evaluation of the "partner in patient care" (PIPC) model. Unique aspects of the model are emphasized, including use of a collaborative process to generate the design and guide the implementation; staff participation throughout the design and implementation of the project; and use of evaluation at each phase of the implementation process to improve on the outcomes.
Computer Terminals↗
Annual assessment of patients aged 75 years and over: general practitioners' and practice nurses' views and experiences.
BACKGROUND: The new contract for general practitioners, introduced in 1990, required them to offer an annual assessment, or 'health check', to patients aged 75 years or more. AIM: A study was undertaken to collect details of practice organization of these assessments, general practitioners' and practice nurses' experience of assessments, and their views of the value of such assessments. METHOD: A nationwide postal survey of 1000 general practitioners and interview surveys with general practitioners and practices nurses from 150 practices were carried out in 1992. RESULTS: The postal survey yielded a response rate of 69% and the interview survey a practice response rate of 76%. Organization of assessments varied enormously between, and often within, practices with a variety of methods of invitation and assessment instruments being used. Of general practitioners 13% did not use a letter of any sort to invite patients to attend, and many doctors excluded certain patients from assessment, particularly those who were seen regularly or had been seen recently. However, 70% of general practitioners estimated that they had assessed over 60% of their elderly patients in the first year (1990-91). A substantial proportion of assessments were estimated to have been conducted on an opportunistic basis and few practices were doing all the assessments of those aged 75 years and over in the patients' homes. In the majority of practices, the general practitioners and practice nurses were the only personnel carrying out assessments. Only 9% of the doctors and 34% of the nurses interviewed had been specially trained to carry out the assessment; 54% of nurses said they would like more training in this area. Both doctors and nurses reported that the assessments did detect previously unknown problems, although over half of doctors reported that they rarely picked up new mental health problems. Increased referrals to social services as a direct result of the assessments were reported by 63% of doctors. The majority of doctors and nurses reported that routine assessments were useful in providing advice and reassurance to elderly people. Two thirds of doctors said they would continue to offer at least selected groups of their elderly patients routine assessments, even if not contractually obliged to do so. CONCLUSION: The findings suggest that the experiences of the first two years of this activity had convinced some general practitioners that routine assessment of elderly patients is worthwhile. However the increased demand for other services must obviously be met by an increase in resources if the effectiveness of these assessments is not to be undermined.
Aged↗
A critical analysis of the potential contribution of Orem's (2001) self-care deficit nursing theory to contemporary coronary care nursing practice.
BACKGROUND: Over the last three decades, nurse theorists have strongly advocated the use of conceptual models of nursing to guide nursing practice. Within coronary care units, conceptual model-based care has had inconsistent application and is currently challenged by contemporary approaches such as pathways of care. AIMS: This paper aims to critically analyze the use of Orem's self-care deficit nursing theory as a modus operandi to effectively meet the needs of hospitalized patients in coronary care. RESULTS: Although complex both in the language and construction, the self-care model , provides a comprehensive and holistic approach to the care of people in coronary care. CONCLUSIONS: This paper highlights the potential contribution the application of the self-care deficit nursing theory to the coronary care setting from a philosophical and practical perspective. Orem's conceptual model of nursing and current practice in coronary care units share certain similarities that render a useful model for use in practice. However, while it is recommended for consideration for use in both practice and educational settings, further empirical work is required in the area, together with realistic and practical application of the theory to practice in a way that embraces contemporary notions.
Coronary Care Units↗
A genetics course for advanced clinical nursing practice.
PURPOSE: To describe a genetics course for advanced clinical nursing practice. BACKGROUND: The Human Genome Project is yielding new discoveries in genetics. The sheer volume of new information threatens to overwhelm healthcare providers as they must find ways to interpret and use these discoveries. DESCRIPTION OF PROJECT: The course was developed in recognition of the fact that graduate nursing students in advanced practice programs need to understand and apply genetic information in the care of their patients. The course builds on core competencies identified by the National Coalition for Health Professional Education in Genetics and the International Society of Nurses in Genetics. OUTCOMES: Students demonstrate that they can access, evaluate, and synthesize current information on a genetic condition and develop a comprehensive plan of care for patients with the selected condition. INTERPRETATION/CONCLUSION: Students learn basic and applied genetic concepts and skills. They are able to utilize resources appropriately to identify patient care needs and develop strategies for meeting those needs. IMPLICATIONS FOR NURSING PRACTICE: The need to remain current in understanding emerging technologies and genetic information will continue to grow as scientific discoveries are made that affect greater numbers of the public. Nurses in advanced practice are in a position to support patients and their families as they deal with the significance of these discoveries for their current and future health.
Curriculum↗