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At least 1,279 records · Page 71Linked to original sources
PubMed2006

Nursing admissions process redesigned to leverage EHR.

Among the challenges facing nurses in acute care facilities are duplicate documentation, complex rules for coordinating care, and pressure to accelerate patient discharge. Christiana Care, a two-hospital, 900-bed health system in Delaware, redesigned its nursing admissions process to address these issues and provide a centralized source of assessment information. An interdisciplinary team redesigned the assessment process to leverage the clinical documentation, decision support, and workflow tools of Christiana Care's evolving electronic health record. Nurses use a wireless device at the patient's bedside to enter admission information. A series of decision-support rules evaluate the information and send electronic referrals to appropriate ancillary departments. Departments electronically document interventions that can be tracked by nursing, closing the loop.A dedicated rollout coordinator and system-generated audit reports were critical to early identification and resolution of several implementation problems. The new process has not only simplified the work of nursing but led to more appropriate referrals to the ancillary departments. More than 25 percent of the patients have information imported from a previous encounter, eliminating duplicate documentation and improving patient satisfaction. Admission information also is being used to monitor and support a variety of quality efforts, including core measures.

Delaware↗
PubMed1999

The new public management and the new nursing: related by rhetoric? Some reflections on the policy process and nursing.

The importance of health policy in terms of its effects on nursing is now recognized as an issue of concern for nurses; however, the essentially dynamic character of policy requires that consideration of its nature and consequences is continuous. This paper addresses the parallel development of the New Public Management (NPM) and the New Nursing as a means of demonstrating the perceived disjunction between events in nursing and the wider policy arena. The nature of policy is discussed and the relationship between the NPM and the New Nursing is explored. An examination of the unintended consequences of policy implementation and the role of rhetoric in the development of the NPM and the New Nursing demonstrates that these contrasting ideologies have emerged from a similar set of circumstances and have developed along a broadly similar timescale. The final effects of this process, however, are not yet clear. It is suggested that although the processes of policy formation and implementation are inherently complex there is an opportunity for nurses to exert some influence over them. Finally it is argued that if nurses become skilled in the art of rhetoric and combine this with a thorough understanding of the policy process they may be able to shape policy directly when and where it is implemented.

Health Care Reform↗
PubMed1992

The role of the assessment nurse: one hospital's vision for meeting Joint Commission standards.

In evaluating the progress made during one year, it is clear that the position of assessment nurse has been an extremely valuable, effective role. The staff nurses' perception is that they not only understand the importance of the nursing process more thoroughly, but they also view the role of nursing administration as that of trying to help the registered professional nurse at the bedside. It is key in today's health care climate that the nursing administrator be visible. One method to assure visibility is for staff to actually see a role model serving as an extension of the nurse administrator. If nurse administrators truly value the importance of the nursing process, then they need to ensure that this message is being communicated throughout the entire nursing service organization. Such an innovative position can function as a liaison between nursing management and the staff. There is no better method of communicating this than having someone who visibly echoes the values of the nurse administrator. It also should be noted here that Shore Memorial Hospital's Nursing Division received a perfect Joint Commission survey evaluation in April 1990. The Nursing Division attributes this to the efforts made regarding implementation of the nursing process, and the forward thinking of a systems change with implementation of a computerized nursing information system that incorporates the nursing process with everyday documentation. Nurse administrators must effect change and demonstrate leadership within their respective organizations. Organizational change can be slow and difficult at times; however, the end result is worth the effort. It is important that the values of the nurse administrator be disseminated throughout the organization.(ABSTRACT TRUNCATED AT 250 WORDS)

Documentation↗
PubMed1995

[University and community health center collaboration].

Nurses from a CLSC in Hull, Quebec are defining a positive role for community health nurses in a multidisciplinary environment. They base their professional day-to-day practice on Orem's conceptual nursing framework. Many of these home care nurses studied in a post-RN baccalaureate nursing program at the University of Quebec in Hull, where they learned different aspects of conceptual frameworks and the nursing process. Two nurse clinicians and a nurse administrator submitted a project based on Orem's model to the administrators of their community health centre. Once it was approved, a nursing professor from the university agreed to act as a consultant and principal researcher to implement the process. The authors describe this three-year collaborative project between home care nurses and the researcher. This includes its objectives, the participants' roles, the tools developed, the process, and the repercussions on nursing care, nurses, and the multidisciplinary team.

Community Health Nursing↗
PubMed1988

Leaping the chasm between nursing theory and practice.

The author considers that whilst nurse tutors teach theory, nurse practitioners go on nursing in the same way that they always have done. There appears to be a chasm dividing theory and practice. This paper describes an attempt to leap that chasm. The paper identifies the problem, inherent in the nursing process that creates such difficulties in its implementation. The nursing process alone does not provide an adequate framework for nursing practice. The paper then describes how the translation of theory into practice took place on a ward in Brighton General Hospital, Brighton, England. The barrier between theory and practice is highlighted, along with a description of how the problems this presents to ward staff were overcome. The author considers that the attribution of cause is a key concept in the problem-solving approach, since it generates the question--Why?--and therefore that attribution of cause must be a concept in any model of nursing that is being used to implement the nursing process. The paper provides an example of how nursing models may be adapted, at ward level, to guide everyday practice, whilst retaining the conceptual framework of the model. The inference of the paper is that such a process could be applied to other models resulting in a greater use of theory in everyday nursing practice.

England↗
PubMed2003

[How is the nursing care process used?].

The author sets out to know the degree of use of the Nursing Treatment Process (NTP) and its possible relationship with these factors: its profile, knowledge about NTP and the Virginia Henderson Model (VHM), nurses case loads and nurses opinions. The subjects in this study have been nurses in the Sant Martí sanitary district in Barcelona. The methodology used consisted in transversal and qualitative descriptive studies performed in 2001; the use of NTP by means of an audit of at home patient visits, NTP-VHM knowledge and profile by means of an anonymous self-administered questionnaire which had 30 theoretical-practical questions; nurses case load study by means of an analysis of the population attended to by nurse per year and nursing activities; and a qualitative study which used opinion questions and interviews.

Nursing Process↗
PubMed2002

Proposing an evidence-based policy process.

Nurses' involvement with policy development may appear more feasible if the policy process is viewed as another example of an evidence-based decision-making process. Evidence-based practice is widely accepted in medicine and across health care as a sound principle or approach when attempting to establish "best" practice. The process of searching for and synthesizing the evidence is applied to the policy design process with the use of policy examples that are relevant to nurse administrators.

Benchmarking↗
PubMedDate not supplied

Care and cure as healing processes in nursing.

Today's health care requires more than technology to accomplish healing. Nursing has a heritage of healing that was highly valued in the past. The care-versus-cure controversy during the past two decades has not identified a clear healing role in contemporary nursing practice. The author explores the concepts of care, cure, and healing as interdependent and indivisible processes within health care and particularly within nursing.

Empathy↗
PubMedDate not supplied

A remediation process for nursing students at risk for clinical failure.

The authors propose a remediation process for nursing students at risk for clinical failure. The process is embedded within the context of clinical evaluation and includes the use of a learning contract as an integral component. The strengths and limits of the process and suggestions for further development are included.

Attitude of Health Personnel↗
PubMed2004

Environmental elements affecting the decision-making process in nursing practice.

BACKGROUND: In their practice nurses constantly make decisions in a dynamic context including complex situations. Besides affecting elements related to the decision-maker and the task itself, the setting where the decision-making process takes place are of decisive importance to the quality of the decision-making outcome. AIM: The aim of this study was to explore environmental elements related to the decision-making process in nursing practice. METHODS: Six expert nurses, from three Swedish nursing settings, participated voluntarily in the study, which were designed of participated observations in everyday nursing practice. Permission to carry out the study was given by the clinics and an ethical committee. A content analysis was used to analyse the field notes where themes emerged which were found to be environmental elements affecting decision-making process of nurses. CONCLUSIONS: The most striking theme, environmental elements, included the sub-themes interruptions and the work procedures are presented in this report. The implications of environmental elements, are discussed from a perspective of nurses' competence, where the elements could be seen as a facilitator or as a hindrance to developing nursing competence. It were concluded that environmental elements have to be well considered before knowledge can be reached about decision-making in practice. RELEVANCE TO CLINICAL PRACTICE: Interpersonal and technological interruptions were features highlighted in the study, features which could jeopardize the decision-making outcome. Therefore, it is of greatest importance that nurses learn to use decision-making strategies to guarantee patient care security and patient care quality.

Decision Making↗
PubMed1995

Psychiatric nurses' communication with psychiatric patients.

The psychiatric nurses, as a member of the multi-professional mental health team, utilises a goal-directed approach to assist the psychiatric patient in mobilising resources to promote, restore and maintain his mental health as an integral part of his quest for wholeness. This goal-direct approach is the nursing process which comprises assessment, planning, implementing and evaluation. All four steps of the nursing process and the nurse's interaction with the patient are dependent upon therapeutic communication. Therapeutic communication remains important as the core of all nurse-patient interactions. The aim of this research was to explore and describe the viewpoints of psychiatric nurses on their communication with psychiatric patients and to formulate guidelines for psychiatric nurses. Such guidelines should assist nurses with their communication with psychiatric patients, helping in the restoration and maintenance phases of the patients' mental health. Exploratory, descriptive and contextual research was done with the purpose of gaining insight into the viewpoints of psychiatric nurses on their communication with psychiatric patients.

Attitude of Health Personnel↗
PubMedDate not supplied

Recognizing spiritual needs of orthopaedic patients.

Orthopaedic nurses often are well-educated in dealing with patients' physical and psychologic needs but lack education in caring for the spiritual needs of man. Nurses must realize they, themselves, have spiritual needs and must invest in clarifying their own values and beliefs as well as their patients. To perform a complete spiritual assessment, nurses need to become familiar with the concept of spirituality and what it means in the care of patients. Providing spiritual care is individualized and often complex. The nursing process enables the nurse to plan patient care. Providing spiritual care is a challenge orthopaedic nurses must recognize and assume responsibility for.

Humans↗