Nursing Activities (nursing + activity)

Distribution by Scientific Domains

Selected Abstracts

,She's manipulative and he's right off': A critical analysis of psychiatric nurses' oral and written language in the acute inpatient setting

Bridget Hamilton
ABSTRACT:, Remarks such as ,she's manipulative' and ,he's right off' are familiar to psychiatric nurses. This paper critiques the language nurses use in acute inpatient psychiatry services, highlighting the diverse discourses implicated in nurses' writing and speaking about patients. Based on a review of the literature, this paper examines ethnographic studies and discourse analyses of psychiatric nurses' oral and written language. A prominent debate in the literature surrounds nurses' use of standardized language, which is the use of set terms for symptoms and nursing activities. This review of spoken descriptions of patients highlights nurses' use of informal and local descriptions, incorporating elements of moral judgement, common sense language and empathy. Research into written accounts in patient files and records show nurses' use of objectifying language, the dominance of medicine and the emergence of the language of bureaucracy in health services. Challenges to the language of psychiatry and psychiatric nursing arise from fields as diverse as bioscience, humanism and social theory. Authors who focus on the relationship between language, power and the discipline of nursing disagree in regard to their analysis of particular language as a constructive exercise of power by nurses. Thus, particular language is in some instances endorsed and in other instances censured, by nurses in research and practice. In this paper, a Foucauldian analysis provides further critique of taken-for-granted practices of speech and writing. Rather than censoring language, we recommend that nurses, researchers and educators attend to nurses' everyday language and explore what it produces for nurses, patients and society. [source]

Using Nursing Interventions Classification as a Framework to Revise the Belgian Nursing Minimum Data Set

Koen Van den Heede PhD
Nursing Interventions Classification (NIC); Minimale Verpleegkundige Gegevens; ontwikkeling van consensus PURPOSE., To develop the revised Belgian nursing minimum data set (B-NMDS). METHODS., The Nursing Interventions Classification (NIC, 2nd edition) was used as a framework. Six expert nurse panels (cardiology, oncology, intensive care, pediatrics, geriatrics, chronic care) were consulted. Seventy-nine panelists completed standardized e-mail questionnaires and discussed results in face-to-face meetings. FINDINGS., We initially selected 256 of 433 NIC interventions. After panel discussions, plenary meetings, and pretesting, the revised B-NMDS (alpha version) contained 79 items covering 22 NIC classes and 196 NIC interventions. CONCLUSIONS., Consensus building promoted acceptance of the B-NMDS, while the NIC provided a good theoretical basis and guaranteed international comparability. IMPLICATIONS FOR NURSING PRACTICE., The revised B-NMDS instrument can be used to visualize nursing activities in different applications (e.g., financing, staffing allocation). DOELSTELLING., Ontwikkeling van een nieuwe versie van de Minimale Verpleegkundige Gegevens (MVG). METHODE., De Nursing Interventions Classification (NIC, 2nd editie) werd gebruikt als raamwerk. Zes experten panels (cardiologie, oncologie, intensieve zorgen, pediatrie, geriatrie, chronische zorg) werden geraadpleegd. Zeven-en-negentig panelleden vulden gestandaardiseerde e-mail vragenlijsten in en bediscussieerden de resultaten in werkgroepvergaderingen. RESULTATEN., We selecteerden initieel 256 van de 433 NIC-interventies. Na panel-discussies, plenaire vergaderingen, en pre-tests, bevatte de herziene MVG (alpha versie) 79 items uit 22 NIC klassen en 196 NIC-interventies. CONCLUSIES., Het draagvlak voor de herziene versie van MVG werd gecreëerd door het nastreven van consensus. Het gebruik van NIC vormde hierbij een geode theoretische basis en verhoogt het internationaal karakter van de nieuwe MVG. IMPLICATIES VOOR DE VERPLEEGKUNDIGE PRAKTIJK., De nieuwe MVG kan gebruikt worden om de dagelijkse verpleegkundige praktijk zichtbaar te maken in verschillende beleidsdomeinen (e.g., financiering, toewijzing personeel). [source]

Use of NANDA, NIC, and NOC in a Baccalaureate Curriculum

Cynthia Finesilver
BACKGROUND For the last 8 years, NANDA, NIC, and NOC have been successfully introduced to students in fundamentals courses at Bellin College of Nursing. As students progress through the curriculum, the classifications are expanded and applied to various client populations in all settings. The faculty expect students to use NANDA, NIC, and NOC in a variety of ways: during preparation for care of clients, documentation of client care, discussion of clients in postconference; in formal nursing process papers; and in the college laboratory setting. MAIN CONTENT POINTS Through the use of standardized languages, which address all steps of the nursing process, students have been able to plan, implement, and evaluate nursing care in all settings, from primary care to specialty care areas. Application of the NANDA, NOC, and NIC frameworks into a baccalaureate curriculum is desirable because the classifications are research based, comprehensive, and based on current nursing practice. NOC and NIC include physiologic, psychosocial, illness prevention and treatment, health promotion, and alternative therapies. Because of the universal and clinically meaningful language, students are able to communicate and document nursing activities in diverse settings and better define the unique actions and value of nursing. Feedback from students and faculty has been positive. Faculty members are encouraged to refine and alter course expectations related to NANDA, NOC, and NIC as needed. Students in the fundamentals courses adapt easily to NANDA, NOC and NIC during small group work and during discussion of common client problems, such as constipation. CONCLUSIONS Although the frameworks are not used as part of the organizing framework, they are used to teach nursing process and increase students' critical thinking and problem-solving capabilities. [source]

Postdischarge nursing interventions for stroke survivors and their families

Kelly L. McBride MSc RN
Background. The physical, cognitive, and emotional sequelae of stroke underscore the need for nursing interventions across the continuum of care. Although there are several published studies evaluating community interventions for stroke survivors, the nursing role has not been clearly articulated. Aim. The aim of this paper is to report a study to describe, using a standardized classification system, the nursing interventions used with stroke survivors during the initial 6 weeks following discharge home. Methods. In the context of a randomized controlled trial, two nurse case managers provided care to 90 community-dwelling stroke survivors who were assigned to the intervention arm of the trial. The nursing documentation was analysed, using the Nursing Intervention Classification (NIC) system, to identify and quantify the interventions that were provided. Findings. Stroke survivors received, on average, six different interventions. There was a trend for those who were older, more impaired, and who lived alone to receive more interventions. The most commonly reported interventions included those directed towards ensuring continuity of care between acute and community care, family care, and modifying stroke risk factors. The study was limited to the nursing documentation, which may represent an underestimation of the care delivered. Conclusions. The NIC system was useful in capturing the interventions delivered by the nurse case managers. Nursing interventions are often not clearly articulated and less often use standardized terminology. Describing nursing activities in a standard manner will contribute to an increase in nursing knowledge and to evidence-based practice. [source]

Identification of priorities for nursing research in Spain: a Delphi study*

Teresa Moreno-Casbas MSc RN
Identification of priorities for nursing research in Spain: a Delphi study Aim.,The aim of this work was to identify priorities for nursing research in Spain. The Co-ordination and Development of Nursing Research Centre (Investén-isciii group) carried out the study using the Delphi technique during the period April 1998 to January 1999. Methods.,Study subjects were professionals involved in different nursing activities. From 1250 eligible professionals initially contacted, 452 (38%) responded in round 1 and 258 (57%) in round 2. But only 189 filled out correctly the questionnaires from both rounds of data collection (overall response rate was 21·6%). Results.,The participants identified priorities related to continuity and co-ordination of nursing care, quality of nursing care, impact of invasive techniques and treatments on the quality of life of patients, needs of the primary care givers, quality of life among elders, satisfaction of customers and needs of terminal patients and their families. [source]

Nursing care quality and adverse events in US hospitals

Robert J Lucero
Aim., To examine the association between nurses' reports of unmet nursing care needs and their reports of patients' receipt of the wrong medication or dose, nosocomial infections and patient falls with injury in hospitals. Background., Because nursing activities are often difficult to measure, and data are typically not collected by health care organisations, there are few studies that have addressed the association between nursing activities and patient outcomes. Design., Secondary analysis of cross-sectional data collected in 1999 from 10,184 staff nurses and 168 acute care hospitals in the US. Methods., Multivariate linear regression models estimated the effect of unmet nursing care needs on adverse events given the influence of patient factors and the care environment. Results., The proportion of necessary nursing care left undone ranged from 26% for preparing patients and families for discharge to as high as 74% for developing or updating nursing care plans. A majority of nurses reported that patients received the wrong medication or dose, acquired nosocomial infections, or had a fall with injury infrequently. However, nurses who reported that these adverse events occurred frequently varied considerably [i.e. medication errors (15%), patient falls with injury (20%), nosocomial infection (31%)]. After adjusting for patient factors and the care environment, there remained a significant association between unmet nursing care needs and each adverse event. Conclusion., The findings suggest that attention to optimising patient care delivery could result in a reduction in the occurrence of adverse events in hospitals. Relevance to clinical practice., The occurrence of adverse events may be mitigated when nurses complete care activities that require them to spend time with their patients. Hospitals should engage staff nurses in the creation of policies that influence human resources management to enhance their awareness of the care environment and patient care delivery. [source]

An evaluation of nursing practice models in the context of the severe acute respiratory syndrome epidemic in Hong Kong: a preliminary study

Engle Angela Chan PhD
Aim and objective., Like other health-care workers, Hong Kong nurses had their professional knowledge and skills seriously challenged during the SARS outbreak. Could current nursing practices support the care of SARS or SARS-like patients in the future? If not, alternative practices would be needed. Providing a preliminary understanding, this paper compares the conventional with different nursing delivery models in a simulated SARS ward and focuses on nurses' efficiency, infection control practices and views of the two models. Design and methods., This study was conducted in three phases. First, a baseline understanding of nursing practices was achieved through four workflow observations. In an eight-hour day, four research assistants observed nursing activities in the medical and fever wards. These data were used in the second phase to construct two sets of clinical vignettes, pertaining to SARS patient care in both conventional and alternative practice models. These scripts were discussed with nine nurses of various ranks from the hospital under study for their expert validation and input. In the third phase, nurse participants and patient actors enacted the vignettes in a simulated setting. Video-taped observations and four nurse participant interviews were employed. Observational data were analysed through descriptive statistics and independent t -tests. Textual data were coded and categorized for common meanings. Results., Conventional practice from the findings consisted of cubicle and named nurse nursing. While the former reflected modified team and functional nursing, it did not confine patient care within a cubicle as suggested by its name. The latter depicted a modified primary nursing approach in a team, with delegation of care. Preliminary findings concerning infection control and nurse satisfaction revealed that the alternative model had an advantage over the conventional. Relevance to clinical practice., This study findings lay the foundation for clinical trials, which would evaluate the significance of patient-care quality, cost-effectiveness and better human resource management by restructuring current nursing practices. [source]

Nurses' use of time in a medical,surgical ward with all-RN staffing

Dipl., S. Lundgren RN
Aims, To investigate allocation of nursing time, organisation of nursing activities and whether or not allocation and organisation have changed over time. Background, In a ward that changed to all-RN staffing, the nurses were encouraged to implement a patient-focused philosophy. The nurses perceived that they had difficulty in using the time available efficiently. Methods, Non-participant observations were conducted with 2-year intervals. Ten consecutive weekdays were covered on two occasions. The study was carried out at a university hospital in Sweden. Findings, Between observations, a significant change in the organization of the direct care had occurred, and the same tendency was found in patient administration and general management. The organization of work changed from a partly fragmented to a more coherent one. The time used for direct care and administrative activities increased between the two observations, while indirect care, personal and service activities decreased. Conclusion, It can be suggested that the nurses used their time efficiently and, over time, they developed a more coherent way of organizing nursing activities. [source]

Avian influenza: risk, preparedness and the roles of public health nurses in Hong Kong

Georgina Ho
This paper provides an overview of the Hong Kong government's influenza preparedness plan and the key roles of public health nurses in that plan. The part played by Hong Kong public health nurses in the management of the avian influenza outbreak in Hong Kong in 1997 and the sudden acute respiratory syndrome outbreak in 2003, together with the capacity-building work they are now undertaking in preparing for an influenza pandemic, highlight their crucial role in public health. Recent strengthening of public health infrastructure in Hong Kong and heightened public awareness of public health issues have facilitated more proactive and effective public health nursing activities. [source]

Modelling nursing activities: electronic patient records and their discontents

Els Goorman
Modelling nursing activities: electronic patient records and their discontents A fully integrated and operating EPR in a clinical setting is hard to find: most applications can be found in outpatient or general practice settings or in isolated hospital wards. In clinical work practice problems with the electronic patient record (EPR) are frequent. These problems are at least partially due to the models of health care work embedded in EPRs. In this paper we will argue that these problems are at least partially due to the models of health care work embedded in current EPRs. We suggest that these models often contain projections of nurses' and doctors' work as it should be performed on the ward, rather than depicting how work is actually performed. We draw upon sociological insights to elucidate the fluid and pragmatic nature of healthcare work and give recommendations for the development of an empirically based EPR, which can support the work of nurses and other health care providers. We argue that these issues are of great importance to the nursing profession, since the EPR will help define the worksettings of the future. Since it is a tool that will impact the development of the nursing profession, nurses have and should have a stake in its development. [source]

Defining the nursing contribution to patient outcome: lessons from a review of the literature examining nursing outcomes, skill mix and changing roles

Karen Spilsbury BA
, ,A review of the evidence to define the nursing contribution to patient outcome is presented. The review relies on work related to nursing sensitive outcomes, skill mix and changing roles. , ,Methodological difficulties associated with these studies are highlighted. , ,Areas requiring further research are discussed. , ,It is suggested that experimental evidence is not always appropriate, when attempting to describe nursing activity. The authors advocate that new methodologies, in particular practitioner-centred research, are needed to unpack the nature of nursing. [source]

Dismantling formal observation and refocusing nursing activity in acute inpatient psychiatry: a case study

P. Dodds RMN

Developing Political Competence: A Comparative Study Across Disciplines

Joanne W Rains D.N.S.
Political activism is one way that nurses care for individuals and communities, and intervene in the broad range of socioeconomic factors influencing health. Though policy advocacy is a core public health function and a valuable nursing activity, the process of acquiring requisite skills and attitudes for political involvement is not often explored. What crucial experiences enfranchise nursing students toward future policy involvement? What is the student journey toward political competence? Do nursing students vary from students of other disciplines in this process? In-depth interviews were conducted with baccalaureate nursing students and political science students who were near graduation. Content analysis of interview transcripts revealed several themes. Despite rich examples of activism, nursing students viewed public policy as a barrier, and did not see connections between the personal, professional, and political. Nursing seemed grounded in application and service, demonstrating by involvement that they could "walk the walk." Political science involvement originated in theory, and resulted in more articulate discourse on the subject: they could "talk the talk." The data suggest a need for interdisciplinary dialogue, faculty modelling of political competence, opportunities for students to realize personal, professional, and political connections, and a concern of socialization in the context of global citizenship. [source]