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At least 19 recordsLinked to original sources
PubMed1992

Seniors for Justice: a political and social action group for nursing home residents.

This article describes a political and social action group of cognitively intact nursing home residents. Organized in response to residents' desire to "do something" about social issues, the group is coordinated by one of the nursing home's recreational therapists, who expected participation in the group to maximize residents' autonomy and sense of control. Benefits mentioned by the participants included: the opportunity to communicate their thoughts, keeping busy, and feeling part of the larger community.

Aged↗
PubMed2006

[Optimizing the nursing process by new management instruments. The Northern Germany Nursing Research Network].

The Northern Germany Nursing Research Network (Pflegeforschungsverbund Nord) has dedicated itself to developing management instruments intended to optimize the nursing process. It is coordinated by the administrative office of the Institute of Public Health and Nursing Research (Institut für Public Health und Pflegeforschung IPP, director: Prof. Dr. Stefan Görres), Department of "Interdisziplinäre Alterns- und Pflegeforschung", University of Bremen. Four partial projects are currently being worked on in two groups: Group A--"Deficient areas of nursing action": The projects belonging to this group are "Individual care-patterns of elderly people and their determinants" (University of Bremen) and "Mobility Restrictions in Nursing Homes-Multicentre Observational Study (MORIN)" (University of Hamburg). The purpose of these studies is to examine the relevance of quantitatively significant risk combinations from a nursing science perspective. Group B--"The generation and testing of nursing action management instruments": The projects in this area are "Nursing rounds as instruments of quality assurance in home-based care" (University of Applied Sciences, Bremen) and "Predicting the risk of falls, efficiency of standard scales in opposition to nursing assessment-Cluster-Randomised Controlled Trial (PROFESSION)" (University of Hamburg). These studies concentrate in a unique manner on the generation and testing of management/control instruments suitable for application to nursing action.

Activities of Daily Living↗
PubMed2000

Quality of service in nursing homes.

This paper illustrates the relevance of using the Servqual instrument as a service quality measurement tool in the healthcare context. The expectations and perceptions of nursing home residents and their relatives are compared and contrasted to determine the priorities and satisfaction levels of both groups with respect to the services provided. Some interesting differences emerged between the two respondent groups, which gave more accurate and relevant pointers as to potential areas of future improvement. Because a number of nursing homes were surveyed, it was also possible to ascertain which homes might serve as useful examples of the best practice and which were in need of improvement action. In frail, elderly respondent groups it is not especially easy to elicit views as to quality of service. Servqual, carefully and sympathetically designed and applied, proved appropriate for this task.

Aged↗
PubMed1988

Medication management.

The elderly receive more drugs than any other patient group, and those in nursing homes receive the most. However, little is known about drug action, particularly in the very old. A host of factors can alter drug action. Particular attention needs to be paid to the influence of intercurrent disease, other drugs in a particular regimen, the patient's weight and nutritional status, as well as altered pharmacokinetic and pharmacodynamic characteristics of any drug. Liver and kidney status, and changes therein, are most important.

Aged↗
PubMed2005

Improving pressure ulcer prevention in a nursing home: action research.

A study conducted in Sunderland investigated how staff in a private sector care home manage pressure ulcer prevention and what staff perceive to be the reasons why residents in their care develop pressure ulcers. It also identified how using a collaborative action research study design (utilizing an action research cycle with collaborative focus groups) can bring about an improvement in practice, by allowing the staff to reflect on and analyse the way they work and develop and implement strategies to provide solutions to the problems they identify.

Focus Groups↗
PubMed1993

[Integration of a nursing model into a local community service center].

Four years ago, maternal/child health nurses from the Metro CLSC in Montreal found themselves in a crisis situation. They were unable to evaluate their work--which consisted of varying tasks and the need for these nurses to be everywhere at the same time. A need to reflect on the situation prompted the team to meet for three hours twice monthly to analyze the problems and establish a plan of action. A nurse-counsellor guided the initial process. A post-natal home visit was chosen as an example for discussion. The group conceded that each member of the perinatal team had a different philosophy and nursing approach. The team consisted of nurses of various ages, experiences and educational backgrounds. Some nurses felt more comfortable expressing themselves in English while others preferred French. At times this group diversity hindered the communication of ideas as well as the ability to reach a consensus about required practice changes. The McGill Nursing model from McGill University was chosen and integrated into the team's practice. The author presents this model and outlines it's advantages and disadvantages. She illustrates this model with the use of an ecomap designed by Wright and Leahy (1984). This nursing model addresses the use of forces within each individual as well as the family. Since it takes into account the extended family, it allows a global approach to care. The article focuses on the essential elements of integrating the model, including it's development and how it was accepted by these nurses. According to the author, the process of changing to this model is dynamic and continuous.(ABSTRACT TRUNCATED AT 250 WORDS)

Community Health Nursing↗
PubMedDate not supplied

Our peritonitis continuous quality improvement project: where there is a will there is a way.

Peritonitis was a significant problem for our peritoneal dialysis patients in 2003. In January 2004, we initiated a continuous quality improvement project to address the problem. Our project took 18 months to complete. We developed many action items. Our first step was to analyze the data to ensure accuracy, and also to determine the causative organism that contributed most to the problem. The other steps we took included more education for the home dialysis nurses, creation of a home visit form, revisions to routine doctors' orders, revision of PD education tools, use of specialty materials for high-risk patients, one-time use for all drain equipment, change to peritonitis treatments and, lastly, group education for our patients. After taking all of these steps, there was no improvement to our peritonitis rates after a 12-month period. New action items were developed and included making changes to patient training and developing a home visit protocol. We also created a partnership with our local Community Care Access Centre and taught our community nurses how to help our patients with their peritoneal dialysis. It was after implementing these last changes that we noticed a significant improvement in our peritonitis rates. It was a lengthy and challenging process to go through but in the end, we are very pleased with our results. Not only has this improved the quality of our patients' lives, it has cut costs to our program, and has also helped us to expand our program significantly.

Aged↗
PubMed2006

Protecting sick children from exposure to passive smoking through mothers' actions: a randomized controlled trial of a nursing intervention.

AIMS: The aim of this study was to evaluate the effectiveness of a nursing educational intervention with mothers of sick children to decrease passive smoking exposure. BACKGROUND: Passive smoking represents a serious health hazard and is a substantial threat to child health causing major risk factors for acute respiratory illness in children. Nurses are in a vital position to conduct health education to improve children's health, which is a legitimate activity in a pediatric ward. METHODS: A randomized controlled trial was conducted in the general paediatric wards of four major hospitals in Hong Kong. The participants were non-smoking mothers of sick children admitted to the paediatric ward and with smoking husbands living in the same household. FINDINGS: A total of 1483 women were randomized into the intervention (n = 752) and control (n = 731) group. The intervention group received from the nurses (1) standardized health advice; (2) two purpose-designed booklets about preventing exposure to passive smoking and helping fathers quit; (3) a no smoking sticker; and (4) a telephone reminder 1 week later. No intervention was given to the controls. Baseline comparison showed no significant differences between the two groups in the mothers' actions to protect the children from passive smoking exposure. More mothers in the intervention group than the control group had always moved the children away when they were exposed to the fathers' smoke at home at 3-month follow up (78.4% vs. 71.1%; P = 0.01) but became non-significant at 6 and 12 months. CONCLUSIONS: A simple health education intervention provided by nurses to the mothers in a busy clinical setting can be effective in the short-term to motivate the mothers to take actions to protect the children from exposure to passive smoking produced by the fathers.

Adolescent↗
PubMed2004

Families in home care--a resource or a burden? District nurses' beliefs.

BACKGROUND: Caring for families in home care is a growing part of Swedish district nurses' professional work. District nurses' facilitative and constraining beliefs about families guide the extent to which families are acknowledged and engaged in the care. AIMS AND OBJECTIVES: The aim of the study was to explore district nurses' beliefs about families in home care. DESIGN: Explorative, descriptive. METHODS: Five district nurses participated in focus group interviews on three separate occasions. Each interview lasted approximately 90 minutes, was audio taped and transcribed verbatim. A thematic content analysis was used for analyses of the data. RESULTS: The result revealed two underpinning beliefs held by the district nurses towards families in home care: families are a resource and Families are a burden. Families could be a resource for the patient, for the other family members as well as for the district nurses themselves. Families could be a resource for the patient both practically and emotionally by e.g. being present and listening. Being open in communication with other family members and district nurses was also considered as a resource. The district nurses considered families as a burden when they were experienced as demanding in various ways, for example, when family members did not act in a way that pleased the district nurses or when family members showed their suffering. CONCLUSIONS: This study highlight some facilitating and constraining beliefs held by district nurses: families can be both a resource and a burden. RELEVANCE TO CLINICAL PRACTICE: It is important that district nurses are aware of what beliefs they hold as their beliefs guide their actions towards the families.

Attitude of Health Personnel↗
PubMed2005

Development and evaluation of a multifaceted ergonomics program to prevent injuries associated with patient handling tasks.

PROBLEM STATEMENT: Nurses have one of the highest rates of work-related musculoskeletal injury of any profession. Over the past 30 years, efforts to reduce work-related musculoskeletal disorders in nurses have been largely unsuccessful. SPECIFIC AIMS: The primary goal of this program was to create safer working environments for nursing staff who provide direct patient care. Our first objective was to design and implement a multifaceted program that successfully integrated evidence-based practice, technology, and safety improvement. The second objective was to evaluate the impact of the program on injury rate, lost and modified work days, job satisfaction, self-reported unsafe patient handling acts, level of support for program, staff and patient acceptance, program effectiveness, costs, and return on investment. INTERVENTION: The intervention included six program elements: (1) Ergonomic Assessment Protocol, (2) Patient Handling Assessment Criteria and Decision Algorithms, (3) Peer Leader role, "Back Injury Resource Nurses", (4) State-of-the-art Equipment, (5) After Action Reviews, and (6) No Lift Policy. METHODS: A pre-/post design without a control group was used to evaluate the effectiveness of a patient care ergonomics program on 23 high risk units (19 nursing home care units and 4 spinal cord injury units) in 7 facilities. Injury rates, lost work days, modified work days, job satisfaction, staff , and patient acceptance, program effectiveness, and program costs/savings were compared over two nine month periods: pre-intervention (May 2001-January 2002) and post-intervention (March 2002-November 2002). Data were collected prospectively through surveys, weekly process logs, injury logs, and cost logs. RESULTS: The program elements resulted in a statistically significant decrease in the rate of musculoskeletal injuries as well as the number of modified duty days taken per injury. While the total number of lost workdays decreased by 18% post-intervention, this difference was not statistically significant. There were statistically significant increases in two subscales of job satisfaction: professional status and tasks requirements. Self-reports by nursing staff revealed a statistically significant decrease in the number of 'unsafe' patient handling practices performed daily. Nurses ranked program elements they deemed to be "extremely effective": equipment was rated as most effective (96%), followed by No Lift Policy (68%), peer leader education program (66%), ergonomic assessment protocol (59%), patient handling assessment criteria and decision algorithms (55%), and lastly after action reviews (41%). Perceived support and interest for the program started at a high level for managers and nursing staff and remained very high throughout the program implementation. Patient acceptance was moderate when the program started but increased to very high by the end of the program. Although the ease and success of program implementation initially varied between and within the facilities, after six months there was strong evidence of support at all levels. The initial capital investment for patient handling equipment was recovered in approximately 3.75 years based on annual post-intervention savings of over $200,000/year in workers' compensation expenses and cost savings associated with reduced lost and modified work days and worker compensation. CONCLUSIONS: This multi-faceted program resulted in an overall lower injury rate, fewer modified duty days taken per injury, and significant cost savings. The program was well accepted by patients, nursing staff, and administrators. Given the significant increases in two job satisfaction subscales (professional status and task requirements), it is possible that nurse recruitment and retention could be positively impacted.

Absenteeism↗
PubMedDate not supplied

Thrombolysis for acute ischaemic stroke: core nursing requirements.

This article describes a nursing protocol for patients treated with thrombolysis for acute ischaemic stroke developed during the Stroke Association phase of the Third International Stroke Trial (IST-3), a randomized controlled trail of recombinant tissue plasminogen activator for acute ischaemic stroke. The IST-3 nurse collaborative group met three times over 3 years. The meetings consisted of educational updates on stroke thrombolysis, training on trial procedures, presentations by participating nurses and discussions of good practice, local initiatives and sharing common problems. Lack of knowledge, fear of bleeding complications and lack of appropriate NHS beds were common barriers. Core nursing requirements suggested by this research included: fast tracking of patients; access to trained stroke physicians; acute physiological monitoring and nursing intervention; effective communication and support of patients and carers; knowledge of complication and actions to be taken; transfer to an appropriately skilled stroke unit environment and successful discharge planning to home or rehabilitation.

Acute Disease↗
PubMedDate not supplied

[Improving adequacy for drug use and effects in geriatric centers using an intervention program].

OBJECTIVE: To evaluate the impact of a program for increasing adequacy of drug prescriptions in a group of nursing homes 2 years after implementation. METHOD: This quasi-experimental before and after study was carried out with a control group in various centers. It included all outpatient prescriptions, individualized by centre, during the study period (reference: year 2001 and post-intervention: year 2003) with 107/118 nursing homes from the Región Sanitaria del Barcelonés Norte y Maresme (Barcelona) included in each period. After an initial situation analysis, centers were assigned to two different groups: intervention group (n = 32) and control group (n = 75/86). Number of residents: 4,798/5,816 (years: 2001/2003). Actions accomplished in the intervention group were: a) presentation letter, b) informative interview c) management control and d) monitorization with follow-up interviews. Quantitative (total cost of drugs among residents) and qualitative indicators (high intrinsic pharmacologic value drug use, generic drug use and super-night diaper use) were established as measurement units, together with relative use values. RESULTS: In the intervention group, cost contention was evident. Cost per resident was 1,671.89 EUR +/- 458.33 EUR in the reference period and 1,821.22 EUR +/- 311.88 EUR during the post-intervention period (inter-annual increment of 8.9% vs. 19.5% compared to the control group; p = 0.002). Number of packages per resident showed an inter-annual increment of 2.5% and 11.4% (p = 0.001) respectively. An increased use of generic drugs (7.9% and 18.4%), antiasthmatic agents, omeprazol and recommended nonsteroidal antiinflammatory agents was observed; while there were no differences in the use of antidepressants and antibiotics. CONCLUSIONS: The preliminary results have shown improved efficiency of pharmaceutical prescriptions in nursing homes included in the intervention group. The methodology used appears to be appropriate for promoting rational use of drugs and improving prescription quality.

Aged↗
PubMed1975

Practical care for the family of a child with cancer.

Support of the child with cancer and his family has two main components: emotional and practical. Since there are already many excellent reviews on emotional care, this discussion covers some of the practical ways to provide help. All the following suggestions are time consuming and some are costly: 1) Physical facilities should include an oncology ward and a special clinic able to provide day care. Adequate arrangements should be availble for parents to stay overnight. 2) Financial resources should be discussed early during the course of the disease to insure adequate coverage and prevent accumulation of debts. Loan and social service funds are a valuable addition to the service. 3) Parent Groups can be organized with differing objectives such as group therapy or community action.

Child↗