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Experienced Nurses (experience + nurse)
Selected AbstractsEstimation of height in elderly Japanese using region-specific knee height equationsAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 3 2002Barbara Lohse Knous Two knee height equations to predict standing height of Japanese elderly were cross-validated with Joetsu City elders. One equation was derived with Hawaiian residents of Japanese ancestry and the other with elders from the Kumamoto Prefecture in Japan. Subjects included 40 men and 39 women free-dwelling, healthy elders with mean ages of 68.0 ± 2.2 years and 68.0 ± 2.7 years, respectively. Heights of the subjects were representative of Japanese elderly. Experienced nurses, trained to measure knee height, also measured standing height with an automatic stadiometer. A pilot study refined measurement skills. Differences between actual and predicted heights for both equations were significant. Multiple linear regression was used to derive knee height equations specific for elderly males and females living in Joetsu City: women, 63.06 + (2.38 × knee height in cm) ,(0.34 × age in years); men, 71.16 + (2.61 × knee height in cm) - (0.56 × age in years). Geographic-specific knee height equations for Japanese elderly and cross-validation with other locations are suggested to facilitate the accurate use of knee height in nutritional assessment of Japanese elders. Am. J. Hum. Biol. 14:300,307, 2002. © 2002 Wiley-Liss, Inc. [source] Practical nurses in elder care and changes in Finnish society , a biographical studyJOURNAL OF ADVANCED NURSING, Issue 2 2003Leena Paasivaara MNSc Background. ,Substantial changes in the socio-economic circumstances in Finnish society over the past century have resulted in major changes in the case of older people, and in the status of nursing staff who care for them. Aim. ,The purpose of this study was to describe and analyse the work of practical nurses in elder care through the experiences and life cycles of two practical nurses with a long working experience. Methods. ,The data consisted of oral biographical narratives produced by the two nurses in repeated interviews. The data were analysed using inductive content analysis. Findings. ,The following chronological stages and periods of the work of the informants emerged as the core themes of elder care: (1) Collective institutionalized care in the 1950s,1970s: The lowest caste in training, obedient subordinates, undemanding service and routine work; (2) Elderly orientated institutionalized care in the 1980s and 1990s: From subordination to co-operation as an experienced nurse, recognizing the specific qualities of the elderly; (3) Prospects of elder care from the 1990s onwards: Returning to custodial care? Conclusions. ,The themes are related to the more general changes that have taken place in Finnish society and health care. The future prospects of practical nurses seem challenging because the principles of social work and health care in Finnish society have shifted from institutionalization towards community care. As a consequence, practical nurses are required to have higher qualifications. [source] Two cases of infants who needed cardiopulmonary resuscitation during early skin-to-skin contact with motherJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4pt2 2008Tomohiko Nakamura Abstract Early skin-to-skin contact (SSC) results in significantly better overall performance on all measures of breastfeeding status and duration. SSC is widely believed to be free of adverse effects. We recently encountered two cases having life-threatening episodes during SSC. An experienced nurse should be placed in the delivery room for periodic observation and recording of vital signs of newborns who are in SSC (color, respirations, tone and heart rate) and to alert the physician to any cardiorespiratory changes. The point should also be emphasized to mothers that infants must be observed carefully and medical staff called immediately if the infant displays any vital changes during SSC. [source] Integrating evidence-based practice into the diabetes nurse curriculum in BergenEUROPEAN DIABETES NURSING, Issue 1 2010Perceived barriers to finding, reading, using research in practice Abstract Background: There is rising international interest in developing healthcare systems that are built on the basis of best evidence. However, it is a challenge to integrate evidence-based practice skills into existing educational courses, in a manner that enables students to interpret and use such skills effectively. Aims: To study students' abilities to find, read and critique research literature and to explore students' perceptions of barriers to implementing evidence-based knowledge and skills into their practice. Methods: An evidence-based approach was integrated into the curriculum of a postgraduate diabetes education programme. At the start of the course and after its completion, questionnaire data were collected to assess students' ability to find, read and critique research literature, and students' perceptions of barriers to implementing new knowledge and skills into practice. Qualitative data on barriers to transferring evidence into practice were also collected. Results: Thirty-three experienced nurses (all female), mean age 40 years (SD 7.7; range 28,52 years), mean work experience 12.8 years (SD 7.9; range 3,30 years) attended the course and completed the initial questionnaire. By the end of the course, three students (9%) had left because of maternity leave or health issues, and six students (18%) did not return the final questionnaires. The remaining students reported greater ability to find and critique research literature (increasing respectively from 6.7% to 40.0% and from 27.3% to 41.7% during the course). Perceived barriers of using research in practice were: lack of time (69.7%); workplace environment (30.4%); structural and organisational problems (25.0%). The qualitative findings indicated that hierarchy, fear of negative judgements, competing demands, and fear of change were perceived barriers. Conclusion: Students commented that the course had provided them with enhanced evidence-based practice skills for finding and interpreting research. However, postgraduate training should be linked very closely to the student's workplace, in order to support the transfer of best evidence into practice. Copyright © 2010 FEND [source] A Computerized Nursing Process Support System in BrazilINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Maria da Graça Oliveira Crossetti BACKGROUND Hospital de Clinicas de Porto Alegre introduced the nursing process model as the basis for nursing practice at the hospital more than 20 years ago. A computerized nursing order system based on nursing diagnoses was introduced. The strategies used in the development of the system included establishment of Nursing Diagnosis Work Groups in 1998; systematic analysis of nursing processes based on the work of existing studies, the NANDA taxonomy in 1999; development and implementation of a data collection instrument to analyze the nursing diagnosis process; training of all nursing staff during 1999,2000; meetings between analysts and nursing staff to articulate the nursing process needs the system would be required to support; pilot implementation of the computerized nursing process system in the ICU in February 2000; and hospital-wide implementation in December 2000. The system supports nursing diagnoses and orders. It was developed in-house by the information systems group at the hospital and is implemented as an Oracle database accessed in client server mode over a Windows NT-based Ethernet network. The system is part of the hospital's larger clinical information management system. MAIN CONTENT POINTS The patient care module includes medical orders and nursing orders. On entering the nursing orders module, the user selects a patient and the system presents a list all current orders completed and pending. These orders can be examined, updated, and reprinted, and new daily nursing orders can also be input at this time. The "new order" screen provides the user with any previous orders to ensure consistency in nursing care. New nursing orders are prepared based on the patient history, physical exam, and daily evaluations. Required interventions are identified based on changes in the patient's "basic human needs." This process can be realized through two distinct paths through the nursing care module: one associated with diagnoses and the other with signs and symptoms. A nurse with more clinical experience and knowledge of diagnostic reasoning will opt to develop orders based on diagnoses. After the diagnosis and associated etiology is input, the system generates a list of possible interventions for selection. The duration and frequency of the intervention can then be specified and the order individualized to a patient's particular needs. Less experienced nurses and students will develop nursing orders based on a patient's signs and symptoms. The system generates a list of diagnoses, etiology, and associated basic human needs in response to the signs and symptoms input. The nurse selects the appropriate diagnoses and etiology and the system generates the list of nursing intervention options. Nurses following either path are required to confirm their orders. They then have the option of developing other orders for the same patient until all that patient's basic human needs have been addressed. The orders can be printed but also remain in the system for nursing staff to implement. CONCLUSIONS The application of systematic, evidence-based methods in nursing care results in improved quality of service that conforms to individual patients' basic human needs. [source] The effect of crossing legs on blood pressure in hypertensive patientsJOURNAL OF CLINICAL NURSING, Issue 9-10 2010Rukiye Pinar Aims., The aim of this study was to examine whether there is any difference between BP readings with patients crossing a leg at the knee level and uncrossing during BP measurement. Background., It is clear that numerous factors influence an individual's blood pressure (BP) measurement. However, guidelines for accurately measuring BP inconsistently specify that the patient should keep feet flat on the floor. Design., Repeated measures. Method., Using a mercury-filled column sphygmomanometer, BP was measured at uncrossed leg position, crossed leg position and again at uncrossed leg position in 283 unmedicated or medicated patients. Three experienced nurses specially trained for the study performed BP measurements. Results., The results indicated that BP increased significantly with the crossed leg position. Systolic and diastolic BP significantly increased approximately 10 and 8 mmHg, respectively. Conclusion., Crossing the leg at knee results in a significant increase in BP. Relevance to clinical practice., Leg position during measurement of BP should be standardised and mentioned in publications. [source] Review: the legal duty of care for nurses and other health professionalsJOURNAL OF CLINICAL NURSING, Issue 22 2009Andy Young Aims and objectives., To explore the nature and extent of the legal duty of care in relation to contemporary healthcare practice. Background., The paper seeks to re-frame and update the legal duty of care for clinical nursing practice in the 21st century, taking into account collaborative and partnership working in healthcare practice. Design., Doctrinal legal ,approach'. Method., ,Black letter' legal research methodology used for data collection and analysis. Literature search using Westlaw and LexisNexis database(s) to identify recent common law decisions. Results., There has been a perceptible doctrinal shift away from paternalism and toward patient empowerment and autonomy in the last decade. This has implications for nurses and other healthcare professionals in terms of consenting patients and acting reasonably to ensure quality patient care. Conclusions., A number of experienced nurses are currently assuming extended roles and some are completing medical tasks, traditionally allocated to doctors. These specialist practitioners must remember that additional responsibility invariably means increased professional risk and accountability. Therefore, it is essential that those engaging in advanced nursing practice, fully understand the nature and reach of their professional duty of care and the significance of statutory and common law developments. Relevance to clinical practice., Nurses and other healthcare professionals must update their clinical skills and practice within a legal framework and to certain standards. The cases cited and discussed are relevant to all branches of nursing and indeed to all health professions. [source] The challenge of caring for patients in pain: from the nurse's perspectiveJOURNAL OF CLINICAL NURSING, Issue 20 2009Katrin Blondal Aim., To increase understanding of what it is like for nurses to care for patients in pain. Background., Hospitalised patients are still suffering from pain despite increased knowledge, new technology and a wealth of research. Since nurses are key figures in successful pain management and research findings indicate that caring for suffering patients is a stressful and demanding experience where conflict often arises in nurses' relations with patients and doctors, it may be fruitful to study nurses' experience of caring for patients in pain to increase understanding of the above problem. Design., A phenomenological study involved 20 dialogues with 10 experienced nurses. Results., The findings indicate that caring for a patient in pain is a ,challenging journey' for the nurse. The nurse seems to have a ,strong motivation to ease the pain' through moral obligation, knowledge, personal experience and conviction. The main challenges that face the nurse are ,reading the patient', ,dealing with inner conflict of moral dilemmas', ,dealing with gatekeepers' (physicians) and ,organisational hindrances'. Depending upon the outcome, pain management can have positive or negative effects on the patient and the nurse. Conclusions., Nurses need various coexisting patterns of knowledge, as well as a favourable organisational environment, if they are to be capable of performing in accord with their moral and professional obligations regarding pain relief. Nurses' knowledge in this respect may hitherto have been too narrowly defined. Relevance to clinical practice., The findings can stimulate nurses to reflect critically on their current pain management practice. By identifying their strengths as well as their limitations, they can improve their knowledge and performance on their own, or else request more education, training and support. Since nurses' clinical decisions are constantly moulded and stimulated by multiple patterns of knowledge, educators in pain management should focus not only on theoretical but also on personal and ethical knowledge. [source] The challenges of caring in a technological environment: critical care nurses' experiencesJOURNAL OF CLINICAL NURSING, Issue 8 2008ITU cert, Mary McGrath MSc Purpose., This paper presents and discusses the findings from a phenomenological study which illuminated the lived experiences of experienced critical care nurses caring within a technological environment. Background., While nursing practice is interwoven with technology, much of the literature in this area is speculative. Moreover, there is a debate as to whether and how ,high tech' and ,high touch' are reconcilable; this orientation is referred to as the optimism vs. pessimism debate. On a personal level, the motivation for this study came from the author's 13 years' experience in the critical care area. Method., Following ethical approval, 10 experienced nurses from two cardiothoracic critical care units in Ireland participated in the study. A Heideggerian phenomenological methodology was used. Data collection consisted of unstructured interviews. A method of data analysis described by Walters was used. Findings., The findings provide research-based evidence to illuminate further the optimistic/pessimistic debate on technology in nursing. While the study demonstrates that the debate is far from resolved, it reveals a new finding: life-saving technology that supports the lives of critically ill patients can bring experienced nurses very close to their patients/families. The three main themes that emerged: ,alien environment', ,pulling together' and ,sharing the journey' were linked by a common thread of caring. Conclusion., Experienced critical care nurses are able to transcend the obtrusive nature of technology to deliver expert caring to their patients. However, the journey to proficiency in technology is very demanding and novice nurses have difficulty in caring with technology. Relevance to clinical practice., It is recommended that more emphasis be placed on supporting, assisting and educating inexperienced nurses in the critical care area and that the use of technology in nursing be given serious consideration. [source] Agency nursing work in acute care settings: perceptions of hospital nursing managers and agency nurse providersJOURNAL OF CLINICAL NURSING, Issue 4 2003Elizabeth Manias BPHARM, FRCNA, MNursStud, MPharm Summary ,,There is a paucity of research in investigating agency nursing work from the perspectives of hospital nursing managers and agency nurse providers. ,,This exploratory paper examines the hospital nursing managers' and agency nurse providers' perceptions and experiences of agency nursing work. ,,Individual, in-depth interviews were conducted with three agency nurse providers and eight hospital nursing managers. Because of the lack of previous research in this area, an exploratory, semi-structured interviewing technique was deemed appropriate. ,,Three major themes emerged from interview data: planning for ward allocation, communication and professionalism. ,,In planning for ward allocation, hospital managers were primarily concerned with maintaining adequate numbers of nursing staff in the ward settings. A major concern for agency nurse providers was inappropriate allocation of temporary staff. ,,Communication was valued in different ways. While hospital managers focused on communication between the agency nurse and other permanent members of the health care team, agency providers were concerned with exchanges between agencies and hospital organizations, and between the agencies and agency nurses. ,,For both groups, responsibility for professional development and the status of agency nursing as a career choice for graduate and experienced nurses were the focal aspects for consideration. ,,A limitation of this study is the small number of individual interviews conducted with hospital nursing managers and agency nurse providers. Nevertheless, the findings represent the views of 11 individuals in senior managerial roles. ,,The findings reinforce the need to enhance collaboration between hospitals and nursing agencies, and to examine how divergent views of agency nursing work could be reconciled , with the aim of providing quality patient care. [source] Empowerment, engagement and perceived effectiveness in nursing work environments: does experience matter?JOURNAL OF NURSING MANAGEMENT, Issue 5 2009HEATHER K. SPENCE LASCHINGER RN Aims, We examined the impact of empowering work conditions on nurses' work engagement and effectiveness, and compared differences among these relationships in new graduates and experienced nurses. Background, As many nurses near retirement, every effort is needed to retain nurses and to ensure that work environments are attractive to new nurses. Experience in the profession and generational differences may affect how important work factors interact to affect work behaviours. Methods, We conducted a secondary analysis of survey data from two studies and compared the pattern of relationships among study variables in two groups: 185 nurses 2 years post-graduation and 294 nurses with more than 2 years of experience. Results, A multi-group SEM analysis indicated a good fit of the hypothesized model. Work engagement significantly mediated the empowerment/effectiveness relationship in both groups, although the impact of engagement on work effectiveness was significantly stronger for experienced nurses. Conclusions, Engagement is an important mechanism by which empowerment affects nurses feelings of effectiveness but less important to new graduates' feelings of work effectiveness than empowerment. Implications for nursing management, Managers must be aware of the role of empowerment in promoting work engagement and effectiveness and differential effects on new graduates and more seasoned nurses. [source] | ||||||||||