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PubMedDate not supplied

The nursing work process in care for healthy children at a social security institution in Mexico.

We aimed to analyze the nursing work process directed at care in the Nutrition, Growth and Development Surveillance and Control Program (VNCD) for children under five years at a social security institution in Mexico. The study adopted a qualitative approach and was based on the work category, on conceptions of the work process in health and on institutional analysis. We carried out direct systematic observations and interviews with a group of nurses and their assistants and with mothers who attended nursing appointments with their children. The care process was identified as procedure-centered and based on care protocols, with rapid appointments and little room for interaction between nurses and mothers. However, on some occasions, nurses were capable of producing live work as a result of their self-government, which allowed them to establish a mother/child-centered care nucleus.

Adult↗
PubMed1984

A nursing care plan for the handicapped student.

The purpose of this paper is to encourage school nurses to document the nursing process when caring for the handicapped student. When the nursing process is properly documented, the result is the nursing care plan. This care plan identifies the diagnosed health needs and defines, in behavioral terms, the goals and interventions designed to meet those needs. A nursing care plan serves a three-fold purpose: 1) It provides a framework to bring students to their maximum health potential; 2) It is applicable to the federally-mandated Individualized Education Plan (IEP) because both are written with behavioral, student-centered goals, and interventions; and 3) It demonstrates a clearly defined and essential role of the school nurse with the handicapped student. This paper presents the current concept of the nursing process and concludes with an example of the nursing care plan.

Data Collection↗
PubMed2003

Observations, confirmations and strategies - useful tools in decision-making process for nurses in practice?

The aim of the study was to describe how nurses make decisions on measures in clinical practice. The data-collection method consisted of audio-taped interviews with six nurses. The interviews were then transcribed verbatim. The questions in the interviews were based on nursing situations observed earlier when the nurses initiated and implemented patient-related measures and the focus was on the nurses' experience of decision making. A content analysis was performed. The results show that the nurses' decisions on measures were based on three themes: observation of cues related to the patient's situation, confirmation of information gathered and implementation of action strategies. The results are discussed in relation to earlier empirical research on decision-making activities in the nurse's clinical practice and the nurse's utilization of knowledge during the decision-making process. It is concluded that the nurse's awareness of the patient's situation, together with a well-founded basis for decisions, can have positive effects on the nursing care provided by the nurse.

Cues↗
PubMedDate not supplied

[The changing process in nursing education at the uni settings: potentials and challenges].

This study analyzes changes occurred in the nursing teaching and learning process from Brazilian Schools which pursue the UNI Project, by describing a movement toward change, besides resistance, conflicts, and current challenges involved. It is a qualitative study whose data were gathered by using Focal Groups and documents available in these institutions. Its results show there is a gradual, dynamic and continuous movement toward change, through the search for teaching models that might replace technical rationality with a critical-reflexive proposal. In spite of challenges related to evaluation and individual competencies to overcome resistance and conflicts, we have found that the change process was supported by the creation of participative spaces and horizontal relationships, allowing for a renewed valorization of nursing education.

Brazil↗
PubMedDate not supplied

[The nursing work process: the gap between planning and care delivery].

This article aims at characterizing nurse's and nursing assistant's work process, as well as at analyzing contradictions present in nursing work. Studies on the nursing and health work process, and the communicative action theory were used as its theoretical framework. Based on qualitative research methodology, the empirical material was collected by means of semi-structured interviews with nurses, nursing assistants and physicians on the same work team in a school hospital. Analysis was conducted through the impregnation technique and the identification of thematic units, which were interpreted on basis of analytical categories from the theoretical framework. Results showed contradictions such as the separation between planning and care delivery and the absence of appropriation of nursing knowledge by the agents who are in charge of delivering care.

Humans↗
PubMedDate not supplied

Metacognitive skills in diagnostic reasoning: making the implicit explicit.

The metacognitive skills of monitoring, analyzing, predicting, planning, evaluating, regulating, and revising frame the nursing process and support clinical reasoning. Nurse educators who encourage metacognitive skill acquisition are likely to accelerate student comprehension, understanding, and mastery of nursing diagnosis, nursing process, and clinical reasoning. The models presented in this article have implications for teaching and learning clinical/diagnostic reasoning.

Cognition↗
PubMed2000

Understanding the reimbursement process.

Nurse practitioners must be fiscally responsible to obtain reimbursement for services provided. A thorough knowledge of the reimbursement process is required to accomplish this goal. This article explores the reimbursement process, generation of revenue, and personal productivity determination for nurse practitioners. Parameters for billing using the resource-based relative value scale, the Evaluation and Management Documentation Guidelines, the International Classification of Disease, and the Physicians' Current Procedural Terminology code book are explained.

Disease↗
PubMedDate not supplied

Cultural negotiation: a constructivist-based model for nursing practice.

Combining abstract concepts from grand theories with the pragmatics of nursing practice presents a dilemma for nursing that is being addressed with the emphasis on middle-range theory. The philosophical perspective of constructivism is the foundation for a middle-range theory that links the nursing process to holism through the respective worlds and knowledge of the nurse and client. The nursing process is situated in the context of the cultural worlds of the nurse, client, and health care system and in the greater social context. This model allows the nursing process to be recast in new language that captures the interdependence of the client-nurse interaction. This model accommodates the social values and beliefs of both the health care system and the social context.

Culture↗
PubMed1994

Communication and socialisation (1): An exploratory study and explanation for nurse-patient communication in an ITU.

This exploratory study was designed to determine the state of communication between conscious, intubated and orientated patients, and nurses in an intensive therapy unit (ITU) and the factors that influence this communication. The aim was to determine whether nurses are able to identify the needs and problems of their patients. This was done by examining characteristics of nurse-patient interactions through participant observation, and exploring nurses' attitudes and knowledge of communication and the nursing process. Dissatisfaction with the nursing process and continual difficulty in communicating with conscious intubated patients by ITU colleagues was the stimulus to investigate the state of nurse-patient communication in the unit where the researcher works. In this paper critical evaluation of previous studies of nurse-patient communication in ITUs is followed by presentation of results of the observations and interviews in this study. The discussion that follows focuses on the socialisation of nurses in 'becoming' ITU nurses related to Bradby's (1990) interpretation of status passage, and the effect that this has on the way in which they communicate.

Clinical Nursing Research↗
PubMed2005

Nursing structure, processes, and patient outcomes in army medical centers.

The purpose of this study was to describe patient outcomes in Army Medical Centers, identify differences in outcomes between mixed medical-surgical bed and specialty intensive care units (ICUs), and explore predictive models for outcomes attributable to nursing structure and processes. Data were collected from 138 patients and 103 nurses in four medical-surgical and four ICUs in two Army Medical Centers. Significant differences for unit type were found for length of stay and patient satisfaction with nursing care. Outcome predictive models were modest (adjusted R2 = .16 to .24) and significant for length of stay, satisfaction with nursing care, satisfaction with pain management, and health status following discharge. Exploring differences and commonalities between military and civilian hospitals will ultimately provide insight into ways of improving patient outcomes and bettering the work environment of nurses.

APACHE↗
PubMed1993

The electronic patient records solution.

Automation has been the solution for many business problems, yet few home care agencies have extended computerization beyond the traditional billing and financial functions to the clinical nursing process. Excessive nursing time spent in documentation is arguably the single biggest business problem facing the industry. Why haven't computers been accepted by home care clinicians? How could new advances in technology create virtually paperless home care nursing?

Attitude to Computers↗
PubMed1997

[Electronic data processing in nursing--sketching the problem].

The increasing implementation of computers for nurses has mainly happened without being influenced by nurses themselves. The article identifies three central problems of implementation of information technologies for nurses. First, the economic motivation for implementation is critically analysed. Second, the potential discrepancy between intuitive nursing and structured patient data is discussed. Third, the necessary organisational changes while introducing computers are shown. The article holds the thesis that a successful implementation of information technologies for nursing (and other clinical areas) can only be reached by active participations of nurses.

Electronic Data Processing↗
PubMedDate not supplied

The painful side of reminiscence.

Reminiscence has been shown to be a therapeutic activity that helps people to find meaning in their memories. Through reminiscence on past life events, the older person is able to recapture both the joy and the pain of a life story that he or she has uniquely authored. By using the nursing process, the nurse may address more effectively the painful side of reminiscence and, in so doing, help others to come to terms with unresolved life conflicts.

Aged↗
PubMed2006

Discursive practices in the documentation of patient assessments.

AIM: This paper reports a study analysing the various functions of nurses' documentation of patient assessments. BACKGROUND: Modes of documentation have received much attention in the nursing press since the integration of the nursing process and nursing models. Previous research has shown that current documentation practices do not consistently promote effective communication and evaluation of patient care. A recent systematic review found no evidence that any particular system of documentation improved this situation. However, nurses' documentation serves not only to communicate information to others, but also has a political function as a presentation of what is important and ethically 'right' to report. METHOD: A Foucauldian approach to discourse analysis was used to analyse 45 patient records. FINDINGS: The findings indicate that nurses employ three discernible discursive practices in the documentation of patient assessments: medical, nursing and informal. Each practice has an effect on the presentation of nursing in the documentation. Because of the complex interplay between these practices, nurses present themselves as aligned with the medical profession, as distinct and professional, and as informal in their descriptions of non-biological information. The use of these practices appears to be motivated by the type of information being reporting. CONCLUSION: Existing literature highlights the functional aspects of nursing documentation. In contrast, this paper explores the way in which nurses, through their documentation, constitute themselves and the nursing profession. In this way, nursing documentation is viewed as a social practice and a conduit through which particular power effects are produced and reproduced, rather than simply a matter of, for example, knowledge, individual choice or good practice.

Attitude of Health Personnel↗
PubMedDate not supplied

[Nursing and the family program: a successful partnership?].

This was a qualitative, descriptive study that analyzed the work of the nursing staff in the Family Health Program (PSF: Programa Saúde da Família) in Campinas from 1998 to 2002. As reference, nursing is defined as work. The study was based on interviews with ten workers from the first three family health teams. Thematically, the following issues were addressed: nursing work and team work, emphasizing the activities developed and the nursing work process. Nursing and PSF is a successful partnership that needs to be explored and addressed. By assessing this production of knowledge and procedures, it is possible to identify how broad the work of Brazilian nursing is in Family and Public Health.

Family Health↗