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PubMed1993

Toward successful compliance with JCAHO standard NC.1.

Recommendations resulting from a JCAHO survey can be a true blessing as they force nursing departments to assess critically their professional practice and documentation systems. Systematic preparation, begun at least two years prior to the survey, includes Nursing Administration, a Nursing Documentation Task Force and all staff nurses. Educational consultants assigned to each unit bring nurses up-to-date on nursing process and nursing diagnosis. Mock surveys and cross-training in chart review prepare staff nurses for confident participation in the accreditation process.

Accreditation↗
PubMed1990

Implementing the ten-step monitoring and evaluation process in nursing practice.

Implementation of the ten-step monitoring and evaluation process as recommended by the Joint Commission leads to the development of a program that meets the requirements of the quality assurance standard. The Professional Practice Program at Robert Wood Johnson University Hospital (New Brunswick, New Jersey) demonstrates the application of this process within the Nursing Division. A conceptual model of nursing practice based on nursing diagnosis provides the framework for the program. Responsibility for the system belongs to the professional nursing staff through the election of unit-based representatives.

Academic Medical Centers↗
PubMedDate not supplied

Decision making in professional practice.

There is a large body of work relating to the nursing process but comparatively little on decision making. Two main views exist, namely the rationalist and the phenomenological perspectives. It can be argued that the rationalist perspective is a quantitative approach whereas the phenomenological perspective offers a more holistic view. Intuitive judgment presents problems as it is only used by experts and is difficult to teach. In professional practice the decision-making process and the nursing process work together.

Clinical Competence↗
PubMed1994

Clinical judgment: an integrated model.

Literature on clinical judgment is discussed as a background for proposing an integrated model of diagnostic-therapeutic and ethical reasoning. Information processing and nursing process components related to problem identification and problem solving serve as a framework for the integration of the two domains of clinical reasoning. Discussion focuses on the integration of process components, identification of areas of research, and the use of the model in education and practice.

Clinical Competence↗
PubMed2000

Who cares? Offering emotion work as a 'gift' in the nursing labour process.

Who cares? Offering emotion work as a 'gift' in the nursing labour process The emotional elements of the nursing labour process are being recognized increasingly. Many commentators stress that nurses' 'emotional labour' is hard and productive work and should be valued in the same way as physical or technical labour. However, the term 'emotional labour' fails to conceptualize the many occasions when nurses not only work hard on their emotions in order to present the detached face of a professional carer, but also to offer authentic caring behaviour to patients in their care. Using qualitative data collected from a group of gynaecology nurses in an English National Health Service (NHS) Trust hospital, this paper argues that nursing work is emotionally complex and may be better understood by utilizing a combination of Hochschild's concepts: emotion work as a 'gift' in addition to 'emotional labour'. The gynaecology nurses in this study describe their work as 'emotionful' and therefore it could be said that this particular group of nurses represent a distinct example. Nevertheless, though it is impossible to generalize from limited data, the research presented in this paper does highlight the emotional complexity of the nursing labour process, expands the current conceptual analysis, and offers a path for future research. The examination further emphasizes the need to understand and value the motivations behind nurses' emotion work and their wish to maintain caring as a central value in professional nursing.

Adult↗
PubMed1985

Auditing. A method for evaluating quality of care.

The nursing process is accepted as a major framework for practice; but its integration in the quality assurance process, in a format where the phases of the nursing process are examined in a sequential manner has not been reported. The authors have developed a nursing process audit tool that provides an organized approach for evaluating independent nursing functions based on the nursing process. Each step in the nursing process can be evaluated individually and as a whole. The tool can be used concurrently and/or retrospectively. This tool provides nursing administrators with pertinent data that can be used to improve nursing practice.

Hospital Bed Capacity, 300 to 499↗
PubMedDate not supplied

A concept analysis: the grieving process for nurses.

The concept of the grieving process has been explored extensively in families losing a loved one or in a patient grieving over a terminal diagnosis. The patients and families live through this experience one time. What about the nurse who lives it several times a week by caring for these patients and families? How does a nurse grieve? Little publication and research have been done surrounding the grieving process for nurses. This is a concept analysis that clarifies the grieving process for nurses. Clarifying this process will enable further development of nursing research and education, ultimately benefiting nursing practice and retention.

Adaptation, Psychological↗
PubMed1993

The effects of unit self-management on hospital nurses' work process, work satisfaction, and retention.

A number of innovative practice models have been introduced in an effort to resolve the hospital nursing shortage and improve the working conditions and retention of registered nurses. This study examines the effects of a unit-level self-management model (including salaried compensation and gainsharing) in a number of clinical areas at The Johns Hopkins Hospital in Baltimore, Maryland. In comparisons of nurses on self-managed and traditional nursing units, outcomes examined were nurses' perceptions of their work process, nurses' work satisfaction levels, and nurses' retention. The self-management model is found to increase work satisfaction through effects on two work process variables: coordination of care and effective team performance. The model is also associated with higher retention. Nurses on self-managed units work longer hours but earn increased pay; the effects of hours and pay on work satisfaction and retention are discussed.

Baltimore↗
PubMedDate not supplied

Preparing case reports as a nurse legal consultant.

Nurses acting as legal consultants in malpractice, workers' compensation, or personal injury litigation may be asked to provide a report that assesses a client's past, present, and future healthcare needs. This article describes the composition of such a report, using the nursing process and nursing models. The format illustrates the comprehensive nature of a nurse's contribution to the resolution of legal actions.

Equipment and Supplies↗
PubMedDate not supplied

A nursing muse.

The nursing process and nursing models can obstruct nurses' understanding and prevent them from caring for patients in a personalized way. This article introduces a 'nursing muse' as a way of extending understanding beyond scientific intellectualization.

Humans↗
PubMedDate not supplied

COAD (clinical outcome assessment documentation) charting: using the quality improvement process to meet the new JCAHO nursing standards.

The shortage of nurses has prompted departments across the nation to examine nursing practices in individual healthcare facilities and to initiate changes where relevant. Saint Thomas Hospital, a 571-bed tertiary-care facility, developed a number of strategies designed to allow nurses to focus on skills consistent with professional practice and to reassign technical and clerical duties to other members of the healthcare team. One of the changes implemented was the clinical outcome assessment documentation (COAD) system, which communicates the plan of care without the use of a separate form, expedites charting times, and eliminates duplication. This system also facilitates the documentation of the patient's progress toward outcome-oriented goals. Evaluation of the COAD system after implementation showed improvement in documentation of the nursing process, staff satisfaction with the system, and compliance with the Joint Commission's 1991 nursing standards.

Hospital Bed Capacity, 500 and over↗
PubMed2004

[The effects of PBL (Problem-Based Learning) on the metacognition, critical thinking, and problem solving process of nursing students].

PURPOSE: This investigation examined the effect of PBL on the meta-cognition, critical thinking, and problem solving process. METHOD: The research design was pre-posttest with a nonequivalent control group design. Scenarios for PBL sessions were developed on the basis of textbooks and patients' charts and tested for content validity. Seventy six nursing students who took a 'Nursing Process' course from two nursing schools participated in the experimental group and control group. The experimental group performed PBL during the semester. Meta-cognition and problem solving processes were assessed by questionnaires which were developed using pedagogics. Critical thinking was measured by the CCTST (California Critical Thinking Skill Test) Form 2000. The data was analyzed by repeated measure (pretest-posttest) MANOVA, and correlation analysis. RESULT: PBL improved the participants' meta-cognition and problem solving process but not critical thinking. The relationship between meta-cognition and the problem solving process was supported but the relationship between critical thinking and problem solving was not supported. CONCLUSION: These results suggest that PBL has a positive effect on nursing students' educational outcomes. To improve the problem solving ability of nursing students, PBL should be applied to more subjects in the nursing curriculum.

Adult↗