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PubMed1995

Variations in the processes and structures of cardiac surgery nursing care.

Nurses play an invaluable role as key members of the cardiac surgery patient's medical care team. Over the last century, the nursing profession has become more independent and autonomous. Despite the widespread use of nursing quality indicators, the effect of nursing-specific processes and structures of care on patient outcomes is unknown. Thus, the Processes, Structures, and Outcomes of Care in Cardiac Surgery (PSOCS) study was initiated, in part, to determine the potential effect of nursing processes and structures of care on cardiac surgery patients' risk-adjusted outcomes. In this article, the authors summarize the key components of nursing structures of care incorporated in the PSOCS study. Nursing process variables were not sufficiently designed into the study to address hypotheses relating nursing care processes to patient outcomes. An analysis of the pilot test data from September 1992 to September 1993 demonstrated potentially important variations between the six pilot centers regarding nursing care provider profiles (eg, educational preparation, specialty certification, and experience levels) and nursing staff ratios (eg, within the surgical intensive care unit). When linked to risk-adjusted patient outcomes, these variations in nursing structure of care may offer important insights toward improving the quality of care of cardiac surgery patients.

Adult↗
PubMed2003

[Effects of a computer-assisted system for nursing care documentation on quality and quantity of nursing care documentation].

The University Hospital in Heidelberg has been gathering experience with the computer based nursing documentationsystem PIK since 1998. Its introduction on four pilotwards was systematically evaluated in an intervention study, gaining data to acceptance issues as well as to the quality of nursing documentation, as the nursing process is often not documented in an appropriate manner. Data to quantity and quality of nursing documentation before and after the intervention was gathered by means of a quality checklist, which was developed on the basis of an intensive literature review. To measure a difference in the quality of nursing documentation 20 documents from each of the four wards were assessed at the three assigned points of time by two nursing experts. The assessors stated a significant improvement in documentation quality due to the increase in formal completeness when documenting the nursing process. The content of the documentation as well as the individualization of the nursing care plan still need to be improved.

Attitude to Computers↗
PubMed1995

A decision support database for nurse care planning as part of a hospital information system.

This paper, based on a doctoral thesis, describes the development and evaluation of a computerized care planning database at the Royal Hampshire County Hospital. It is part of an integrated Hospital Information System, the first to be installed in an United Kingdom. The research examines nurses' attitudes to the Nursing Process to the new care planning system before, three months after, and one year after its implementation. The quality of manual vs. computer care planning is compared in the same time periods using an existing quality assurance instrument and an audit tool, developed during the research. All data was analyzed in each time period in a framework of personal and organizational change theories. The proactive nature of the research allowed findings to be used as a basis for modifications during the process, which culminated in a further project to provide a database of standard based care plans. Results showed that an understanding of the Nursing Process was inadequate and that most nurses were ambivalent about paper care planning and the proposed computer care plans. Three months after implementation, attitudes became more unfavorable; however, after a year, attitudes showed a significant shift towards the positive pole. Conversely, the overall quality-of-care planning improved significantly.

Attitude to Computers↗
PubMed1997

Health surveillance: effective components of a successful program.

1. Using the nursing process, the occupational health nurse plays a key role in the health surveillance of workers at risk for exposure to chemical, biological, or physical hazards. 2. To implement and manage a successful occupational surveillance program, the occupational health nurse must be familiar with walk through procedures, test selection and interpretation issues, toxicology and epidemiology concepts and budgeting processes. 3. Employee education and program evaluation are integral and ongoing components of a comprehensive occupational health surveillance program. Anticipation of legal and ethical problems is also critical during the design, implementation, and evaluation of the program. 4. Quality data collection and management aid the occupational health nurse in decision making and accurate and timely record keeping.

Data Collection↗
PubMedDate not supplied

Application of critical pathways in the maternity nursing orientation process.

The creation of an individualized, systematic, and comprehensive clinical orientation is essential for the newly hired nurse, the nurse preceptor, and nursing managers. The development, implementation, and use of "orientation pathways" provides a framework that will produce an individualized orientation based on clinical experience, focus on specific criteria for patient care and unit duties, ensure completion of skill competency criteria within a specified time frame, and assist with identification of problems and/or weaknesses the nurse orientee may be experiencing.

Critical Pathways↗
PubMed1994

GI nursing: the community health aspect.

Much of the research and literature regarding gastrointestinal nursing addresses concerns of clients in the hospital or outpatient setting. This article focuses on a larger clientele, the well elderly aggregate in the community. Implementation of the nursing process with participants of a local senior center indicated the need for a gastrointestinal education program. A GI health program with a long-range goal of reducing the number of deaths caused by colon cancer was developed and presented. The goal of the program was to educate individuals about colon cancer and the importance of early detection. In this article, the authors describe the application of the nursing process with a well elderly population and the results of that experience for the client and for the GI nurse in the community.

Aged↗
PubMed1994

Coordinating multidisciplinary, collaborative research: a formula for success.

Nursing continues to move toward the goal of providing care that is grounded in theory and research. As such, the CNS may perform the role of research nurse coordinator for collaborative research projects. In this article, three nursing principles that were successfully applied to the planning and conduct of multidisciplinary, collaborative research resulting in a high degree of participant satisfaction and subject retention are described. These three nursing principles are: (1) using the nursing process as an organizing framework for nursing practice, (2) delivering nursing care through a process of interpersonal relationships, and (3) allowing a humanistic philosophy to guide nursing actions. Knowledge and application of this "formula for success" will assist the CNS who is a novice at research to achieve a positive outcome in his or her endeavors.

Clinical Nursing Research↗
PubMed2001

The development of critical thinking among students in baccalaureate nursing education.

Students entering nursing education present with a range of critical-thinking skills and dispositions that are affected by genetic influences, modeling by others, and formal learning experiences. The experience of higher education further contributes, positively or negatively, to the development of those skills and dispositions over time. A conceptual framework is presented as a model to explain the relationship between variables contributing to critical thinking as it is manifested in clinical judgment. A developmental model is presented to align the development of cognitive capabilities and the application of those capabilities in the subprocesses of the nursing process. Implications for nurse educators related to the understanding of critical-thinking development of students are discussed.

Clinical Competence↗
PubMedDate not supplied

Rational nursing: a concept analysis for practical application.

Rational nursing is a theoretical concept that serves as a practical, behavioral application of the nursing process. This article is a concept analysis that defines and clarifies rational nursing, examines relational and nonrelational propositions, and describes clinical and personal applications for the individual nurse. This relatively simple yet revolutionary tool can improve patient outcomes and prevent nursing burnout. Nurses involved with staff development, education, and retention will discover that teaching and reinforcing rational nursing provides nurses with minute-by-minute guidance to the treatment of the human response both in patient illness and their own practice of nursing.

Attitude of Health Personnel↗
PubMed2002

Primary prevention of agricultural injuries. Use of standardized nursing diagnosis, interventions, and outcomes.

1. The use of standardized nursing language is important to the advancement of nursing knowledge and practice. The standardization of nursing diagnoses, interventions, and outcomes provides a means for collecting and analyzing large clinical databases. 2. The occupational health nurse has a clear role in developing health and safety programs. Standardized language using North American Nursing Diagnosis Association diagnoses, nursing outcomes classification, and nursing intervention classification can be incorporated into these programs. 3. The use of standardized taxonomies in the primary prevention of cumulative trauma disorders demonstrates how these systems are integrated into the documentation of the nursing process in a nursing care plan.

Accidents, Occupational↗
PubMed2006

Developing a cancer nursing information system: Determining core nursing diagnoses for the six most common cancers in Korea.

The purpose of this study was to determine core nursing diagnoses (CNDs) from NANDA Taxonomy II for a cancer nursing information system supporting the nursing process. The main objective for determining CNDs was to increase the perceived usefulness and the perceived ease of use of the information system by supporting the process of making nursing diagnoses. The CNDs were for each of the patient groups of the six most common cancers in Korea. For the determination of CNDs, a survey and an analysis of patient records were performed. Two hundreds and nineteen clinical nurses participated in the survey and 72 patient records were analyzed. Based on the findings of the survey and analysis of patient records, 15 CNDs for each of the populations were determined.

Humans↗
PubMed1991

Documentation in critical care: a flow sheet format that communicates and saves time.

The design of a critical care nursing documentation form in a flow sheet format provides quick access to and rapid communication about patient information. Assessment parameters can be organized on the form to communicate standards of care, facilitate the nursing process, and save nursing time. The structure of a flow sheet format results in standardized documentation that simplifies quality assurance review and eliminates duplicate documentation. Nursing staff members comment on how easy charting is when the standards for documentation are clear. Staff members no longer waste time charting; they save time communicating. Our goals to effectively and accurately communicate the patient's status and to document nursing care efficiently and accurately have been achieved.

Communication↗