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PubMedDate not supplied

Psychology. 5: Implications of the ageing process for nursing practice.

Many people are living longer and, as a consequence, the UK is populated by increasing numbers of elderly people. This trend towards an increase in longevity has been matched with an increase in morbidity, despite contemporary professional and lay interest in the adoption of healthier lifestyles. Hence, expertise in elderly care is likely to continue to be important for many health-care professionals. This article considers aspects of the ageing process and draws attention to the psychological interpretations of personality and life span, social isolation, intelligence and memory related to elderly people. The main conclusions drawn are that, although becoming older can be associated with health-care problems, the process of ageing is individually experienced and it is inappropriate to assume that all elderly people share common needs. A number of implications for nursing practice are highlighted and recommendations to enhance care are made.

Aged↗
PubMed2004

The effect of a VIPS implementation programme on nurses' knowledge and attitudes towards documentation.

The Copenhagen University Hospital decided to adhere to the standards of the Joint Commission of International Accreditation in 2000. These standards require systematic assessment of patient care needs and include the use of written nursing care plans. In order to meet these standards, the hospital management decided to introduce the Swedish VIPS model, which is a model designed to structure nursing documentation (VIPS is an acronym for well-being, integrity, prevention and safety). The present study explores the nurses' knowledge and attitudes towards documentation and addresses the research questions: (a) what are the nurses' attitudes towards documentation of nursing care? and (b) do nurses have sufficient knowledge of the documentation system to systematically document their patient assessment and clinical decisions? The research design was prospective, comparative, and quasi-experimental (nonrandomized), including a study group (n=72) and a control group (n=57). A questionnaire was used to compare nurses' self-evaluated attitudes towards documentation, and a multiple-choice test was given in order to assess nurses' knowledge of the documentation system. The study group participated in a special implementation programme (response rate 82%), while the control group attended the regular 3-day documentation course at the hospital (response rate 79%). The study showed that the two groups responded similarly, but the nurses in the study group were significantly stronger in their conviction that they had the knowledge to make care plans and that they routinely made them. The study group demonstrated slightly less motivation than the control group, while the two groups shared a positive attitude towards nursing documentation. The study group did consistently better on the knowledge tests. The findings show that the implementation programme had a positive impact on nursing documentation, and that the VIPS model increased the nurses' understanding of the nursing process.

Adult↗
PubMed1993

Developing a perinatal education program.

The process of assessing learning needs and designing and implementing educational offerings for perinatal families is discussed. Common areas of evaluation are examined, and sample questions are presented. Through careful application of teaching principles in conjunction with the nursing process, nurses can effectively develop comprehensive perinatal education programs.

Curriculum↗
PubMedDate not supplied

Revitalizing a documentation system.

The nursing department of a 154-bed acute rehabilitation facility, cognizant of the changing trends in health care and responding to feedback from staff, developed and implemented a comprehensive documentation system. The previous system had been fragmented, inconsistent, and inefficient. The development of the new system focused on the complex needs of the rehabilitation client and the equally complex standards required by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the Commission on Accreditation of Rehabilitation Facilities (CARF), and insurance carriers. The final product, which was based on the nursing process and functional health patterns, encompassed the following areas from admission to discharge: providing feedback on clients' functional abilities and progress toward goals, satisfying requirements of the 1990 JCAHO standards, and, finally, using a flow sheet that saves nursing time and increases objectivity. This article describes the system from conceptualization to successful implementation.

Humans↗
PubMed2005

Enteral nutrition in intensive care nurses' perceptions and bedside observations.

The aims of this descriptive study were to examine (1) nurses' perceptions of responsibility, knowledge and documentation focusing on enteral nutrition and (2) nursing practice regarding enteral feeding in the intensive care unit. Forty-four nurses in three intensive care units responded to a questionnaire (response rate 70%) and 40 bedside observations were performed. The nurses' primary source of knowledge was consultation with colleagues. Regarding responsibility, knowledge and documentation, the focus was more on planning, implementation and prevention than on the assessing phase of the nursing process. Gastric residual volumes were almost never checked, and none of the tubes were labelled. Seven out of 40 bedside observations revealed a backrest elevation of 30 degrees or more. Mean backrest elevation was 20.7 degrees. Comparisons between nurses in the three hospitals revealed significant differences. This study indicates that enteral nutritional nursing care within intensive care has its strength in planning, implementation and prevention of complications. Regarding nutritional assessment, the registered nurses (RNs) scored low. There are gaps between recommended nursing care and nursing practice regarding enteral nutrition. Knowledge and awareness of responsibilities in combination with a systematic documentation could increase the optimal nutritional care of the intensive care patient.

Adult↗
PubMed2002

Evaluating quality of telehealth advice nursing.

Despite an increased interest in advice nursing, the quality of care has not been addressed. This article examines the quality of the nursing process (including problem identification, care planning, intervention, and evaluation) and its relationship to patient (consumer) outcomes. A sample of 157 nonredundant telephone calls from adults with medical-surgical problems were audiotaped, with providers' and callers' consent, and were rated through an implicit review method by registered nurse raters. The quality of the nursing process was found to be the best in the area of intervention. Patient (consumer) satisfaction was high with 95.4% of the consumers rating the calls as completely or at least somewhat satisfying, and 93.2% stating the advice was very or somewhat helpful. This study pioneers a way to rate the quality of advice nursing and lays the groundwork for further investigations of health care provider behavior and consumer outcomes.

Adult↗
PubMedDate not supplied

Professional development framework. Pathway to the future.

Staff development educators in a large midwestern university hospital developed a framework for professional development. The framework, applicable to all nurses, has four levels of professional development, from professional awareness to professional mastery. Within each developmental level five dimensions of nursing practice are identified: nursing process and practice skills, communication/collaboration, leadership, professional integration, and research/evaluation. This framework for professional development is reported and its potential use in the areas of planning, development and evaluation of staff development programs; restructure of a clinical ladder for nurses; and individual career development is discussed.

Communication↗
PubMed1991

A model of clinical judgment processes in psychiatric nursing.

This study addressed judgment processes in psychiatric nursing by analyzing reported use of clinical cues cited as being relevant in the process of making a nursing judgment. Using an exploratory, qualitative approach, data were collected by interviewing 15 subjects who provided 36 in-depth interviews upon completion of an intake interview. Comparative content analysis was used to determine the underlying structure in subject reports. A model depicting judgment processes is presented and discussed. Results suggest that although judgments were highly context-dependent, all subjects assessed data labeled as universals in the psychiatric nursing assessment: suicidality, depression, drug and alcohol use, and patient functional abilities. Similarities among subjects were noted in that presenting behaviors were most salient, a categorization process occurs within the judgment process, and patients are included in the judgment process. Finally, nursing judgments uncovered an action orientation rather than a labeling function.

Adult↗
PubMed1999

The application process for nurse anesthesia programs: is there room for improvement?

In summary, we have observed that competition among programs for applicants has been strong in recent years. We believe the answers to preparation of adequate numbers of CRNAs in the future should be based upon cooperation and major recruitment activities within our geographical area. In addition, the results of this study will help us focus on strengths and areas needing improvement in our application process and programs. This is important to attract well-qualified students and maintain our reputation for excellence.

Choice Behavior↗
PubMed1994

Nurse education and the impact of professionalisation.

This article asks what kind of educational process nurse education can follow. Educational theory offers two views; the rationalist and the humanist perspectives. Both involve problems for nurse education. Professionalisation is identified as the major force determining the educational process in nurse education. It prevents progressive humanist education and reinforces traditional rationalist education. This process continues with integration into higher education. Professionalisation must be abandoned as an occupational strategy, if an alternative educational process is to be developed in nurse education.

Education, Nursing, Baccalaureate↗
PubMed1996

[Hospital infections in teaching hospitals: analysis of their control].

The purpose of this study is to identify methodologies of vigilance and hospital infection control, to analyse nurse's actuation in the context of hospital infection control and to associate nurse's actuation on the control of hospital infection and the execution of nursing process. It is an analytic-descriptive study developed at 81 Commissions of Hospital Infection Control (CCIH) at School Hospitals from 21 Brazilian states through a questionnaire. The variables studied were: characteristics and functioning of CCIH; criteria to diagnose hospital infection; methods of data collection; types of epidemiological vigilance, prevention and control measures and nurse's participation. The analysis of data was qualitative and quantitative. The results showed that in the collection of data prevailed general vigilance (66.6%) and the association of passive and active methods (48.4%); 67 CCIH mentioned measures of prevention and control, related to urinary tract (54 CCIH) and to respiratory tract (21 CCIH). The antimicrobian control distinguishing the lack of resonance between the CCIH and the units personnel brings to the conclusion that the problems of hospital infection control are, in their essence, of philosophical, educational or administrative character. Authors evidenced the importance of the implementation of methodologies to facilitate the control of hospital infection, indicating that the adoption of nursing process, as an instrument, can result in benefits to CCIH and to patients.

Brazil↗
PubMed1994

King's theory: a critique of the critiques.

This article describes Imogene M. King's conceptual framework and theory of goal attainment. The critiques of various nursing scholars reflect a misunderstanding of the intent of the theory and conceptual framework. Major areas of concern of the critics include cultural limitations, patient competence, and lack of specific guidelines to work within the nursing process. These critiques are discussed and examples supporting the use of King's work in practice are presented.

Goals↗
PubMed1998

New tools--new models to integrate outcomes into quality measurement.

Nurse managers are faced with a changing health care system that values measurement of outcomes and performance. Today's nurse managers are confronted with the need for information to make decisions that translate information into knowledge about health care outcomes, effectiveness, efficiency, and quality. These same nurse managers are being held accountable for the efforts of nurses to enhance the health of the public. New models of evidence and outcomes integrated into the models of nursing process are required to measure quality in this new environment. Yet the measurement of outcomes and the measurement of quality should be united in this new paradigm. The author describes new tools available from the Agency for Health Care Policy and Research that could assist nurse managers in delivering and developing computerized patient record systems that capture the evidence, the clinical indicators, and the performance measures to assist in describing the outcomes of care.

Evidence-Based Medicine↗
PubMedDate not supplied

The challenges of a care information system reflecting holistic nursing care.

In this article two recent developments in the German health care system are outlined. On one side, an increasing economic pressure and legal changes on the German health care system lead to growing computerization in German hospitals. On the other side, a shift from functional to holistic nursing is observed. The question is raised if within the paradigm of holistic nursing computer support is an adequate way to organize and design work. The newly developed German care information system, PIK (Pflegedienst im Krankenhaus--Nursing service in hospital), serves as an example for a program that is structured according to the nursing process. On the grounds of this exemplification it is argued that within the concept of "technology as an option" not only is the design of a program important but also its basic work organization and design. The authors come to the conclusion that computer support of holistic nursing is possible. However, it is shown that some aspects of nursing (for example, intuitive knowledge, which has been identified as an integral part of expert nursing) cannot be formalized and thus cannot be supported by computer systems.

Germany↗
PubMedDate not supplied

Fostering critical thinking in nursing students in the clinical setting.

Critical thinking is an important outcome of baccalaureate education in nursing. The authors explore the relationship between critical thinking and the nursing process and propose a model to foster critical-thinking abilities of nursing students in the clinical setting.

Clinical Competence↗
PubMed1994

Preparedness for clinical nursing education.

The identification of individualized patient care planning as a core element in clinical nursing training showed the need to evaluate how nursing students perceive themselves to be prepared for implementing the concept into patient care. Ninety-five nursing students, with a mean age of 27 years, participated in this study at the end of their first theoretical block. Three questionnaires were used; 1) One questionnaire designed for the study concerning demographic data, attitudes and valuation of the theoretical education of the nursing process, 2) Rosenbaum's Self-Control Schedule, and 3) Antonowsky's Sense of Coherence test. The results showed that the students' pre-educational health care experience, which varied from one to twenty years, significantly (p < 0.05) influenced the evaluation of their preparedness for clinical training. Attitudes towards nursing research and development of nursing care were negatively correlated (p < 0.05) to their years of previous experience of health care and positively correlated to a more theoretical school background. The students' personal preparedness to develop independence varied greatly as measured by the Self-Control Schedule and the Sense of Coherence test independently of age, work experience and earlier education. It was concluded that students might be favoured by individualized study planning as a parallel model to individualized care planning.

Adolescent↗
PubMedDate not supplied

Documenting the primary nursing summary note: a leap toward professionalism.

A newly developed documentation tool greatly enhances professional nursing practice, empowerment, and interdisciplinary collaboration. The Primary Nursing Summary Note captures the essence of the nursing process, records and validates it in the interdisciplinary patient progress notes, and facilitates the provision of high quality, cost-effective health care.

Humans↗