PERSONNEL PSYCHOLOGY, Issue 4 2006
DAVID A. HOFMANN
Safety climate has been shown to be associated with a number of important organizational outcomes. In this study, we take a broad view of safety climate,one that includes not only the development and adherence to safety protocols, but also open and constructive responses to errors,and investigate correlates within the health care industry. Drawing on a random, national sample of hospitals, the results revealed that safety climate predicted medication errors, nurse back injuries, urinary tract infections, patient satisfaction, patient perceptions of nurse responsiveness, and nurse satisfaction. As hypothesized, the relationship between safety climate and both medication errors and back injuries was moderated by the complexity of the patient conditions on the unit. Specifically, the effect of the overall safety climate of the unit was accentuated when dealing with more complex patient conditions. [source]

THE SHORTAGE OF NURSES IN GREECE

INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 1 2000
Article first published online: 24 DEC 200
No abstract is available for this article. [source]

MANAGING NEWBORN PROBLEMS: A GUIDE FOR DOCTORS, NURSES and MIDWIVES

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 3 2005
Dr T Duke
No abstract is available for this article. [source]

RURAL NURSE PRACTITIONERS IN SOUTH AUSTRALIA: RECOGNITION FOR REGISTERED NURSES ALREADY FULFILLING THE ROLE

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 1 2004
Judy Bagg
ABSTRACT:The introduction of the nurse practitioner role is hailed as a new initiative in the South Australian public health system. In reality, some registered nurses working in rural public health care facilities have been practicing in the role for many years. The role of the rural registered nurse, the pathway towards achieving rural nurse practitioner status and the anticipated advantages of implementing the rural nurse practitioner role will be presented. [source]

REVISITING THE PAST: THE ASSOCIATION FOR AUSTRALIAN RURAL NURSES COMES OF AGE

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 6 2002
Karen Francis
No abstract is available for this article. [source]

LEARNING ISSUES FOR NURSES IN RENAL SATELLITE CENTRES

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 6 2000
Sally Wellard
ABSTRACT: The introduction of ,satellite' dialysis centres has increased local access to renal services for patients living in rural and remote areas across Australia and is, therefore, consistent with rural health policies. Rural health strategies also aim to maintain and improve the skills of health professionals through regular review of the scope of their practice and evaluation of the education required. Yet, the results of the present national study of nurses working in satellite dialysis centres indicate that, for many, the context of practice influences their ability to access ongoing professional education to support and extend their nursing practice. The present study showed that there was a range of educational backgrounds among nurses working in rural ,satellite' centres with reportedly limited access to specific dialysis-related professional development. In the present paper we report on factors that influence the ability of nurses working in satellite dialysis centres to access ongoing professional education. [source]

CENTRAL AUSTRALIAN NURSE MANAGEMENT MODEL (CAN MODEL): A STRATEGIC APPROACH TO THE RECRUITMENT AND RETENTION OF REMOTE-AREA NURSES

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 1 2000
Melanie Van Haaren
This paper introduces a new strategic approach, the Central Australian Nurse Management Model (CAN Model), to manage remote area nursing services. Central Australia is home to approximately 45 000 people, of whom 30% are Aborigines with a health status that is markedly lower than the rest of the population. While the Federal, State and Territory governments have policies in place to address health inequities, improvement has been hindered by the difficulty in recruiting and retaining suitable nursing staff in remote areas. Implementation of the three key initiatives that comprise the CAN Model has succeeded in attracting, stabilising and skilling a remote area nursing workforce, fundamental to achieving better health outcomes in Aboriginal populations. [source]

Effect of Mandated Nurse,Patient Ratios on Patient Wait Time and Care Time in the Emergency Department

ACADEMIC EMERGENCY MEDICINE, Issue 5 2010
Theodore C. Chan MD
Abstract Objectives:, The objective was to evaluate the effect of mandated nurse,patient ratios (NPRs) on emergency department (ED) patient flow. Methods:, Two institutions implemented an electronic tracking system embedded within the electronic medical record (EMR) of two EDs (an academic urban, teaching medical center,Hospital A; and a suburban community hospital,Hospital B), with a combined census of 60,000/year, to monitor real-time NPRs and patient acuity, such that compliance with state-mandated ratios could be prospectively monitored. Data were queried for a 1-year period after implementation and included patient wait times (WTs), ED care time (EDCT), patient acuity, ED census, and NPR status for each nurse, patient, and the ED overall. Median WT and EDCT with interquartile ranges (IQRs) were analyzed to determine the effect of NPR status of each patient, nurse, and the ED overall. To control for factors that could affect the "within the mandated ratio" and the "outside of the mandated ratio" status, including patient volume and acuity, log-linear regression models were used controlling for specified factors for each hospital facility and combined. Results:, There were a total of 30,404 (50.9%) patients who waited in the waiting room prior to being placed in an ED bed (53.8% at Hospital A and 46.4% at Hospital B). Patients who waited at Hospital A waited a median duration of 55 minutes (IQR = 15,128 minutes), compared with 32 minutes (IQR = 12,67 minutes) at Hospital B with a combined median WT of 44 minutes (IQR = 13,101 minutes). In the log-linear regression analysis, WTs were 17% (95% confidence interval [CI] = 10% to 25%, p < 0.001) longer at Hospital A and 13% (95% CI = 3% to 24%, p = 0.008) longer at Hospital B (combined 16% [95% CI = 10% to 22%, p < 0.001] longer at both sites) when the ED overall was out-of-ratio compared to in-ratio. There were a total of 45,660 patients discharged from both EDs during the study period, from which EDCT data were collected (26,894 in Hospital A and 18,766 in Hospital B). Median EDCT was 184 minutes (IQR = 97,311 minutes) at Hospital A, compared to 120 minutes (IQR = 63,208 minutes) at Hospital B, for a combined median EDCT of 153 minutes (IQR = 81,269 minutes). In the log-linear regression analysis, the EDCT for patients whose nurse was out-of-ratio were 34% (95% CI = 30% to 38%, p < 0.001) longer at Hospital A and 42% (95% CI = 37% to 48%, p < 0.001) longer at Hospital B (combined 37% [95% CI = 34% to 41%, p < 0.001] longer at both sites) when compared to patients whose nurse was in-ratio. Conclusions:, In these two EDs, throughput measures of WT and EDCT were shorter when the ED nurse staffing were within state-mandated levels, after controlling for ED census and patient acuity. ACADEMIC EMERGENCY MEDICINE 2010; 17:545,552 © 2010 by the Society for Academic Emergency Medicine [source]

The process and promise of mental health augmentation of nurse home-visiting programs: Data from the Louisiana Nurse,Family Partnership

INFANT MENTAL HEALTH JOURNAL, Issue 1 2006
Neil W. Boris
The Nurse,Family Partnership (NFP) model is a well-studied and effective preventive intervention program targeting first-time, impoverished mothers and their families. Data documenting the negative impact of maternal depression and partner violence on the developing young child can be used to make a strong case for augmenting NFP programs to focus on mental health problems impacting the mother,child relationship. This article reviews the rationale for and process of augmenting an NFP program in Louisiana. Data on the prevalence of depression and partner violence in our sample are presented alongside a training protocol for nurses and mental health consultants designed to increase the focus on infant mental health. The use of a weekly case conference and telephone supervision of mental health consultants as well as reflections on the roles of the mental health consultant and the nurse supervisor are presented. [source]

Nursing Outcomes for Evaluations of Caregiver Outcomes in a Rural Alzheimer Demonstration Project

INTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003
Janet Specht
PURPOSE To evaluate the effectiveness of the interventions of nurse care managers in the care of family members of people with dementia. METHODS Data were collected as part of a 3-year Administration on Aging,funded Alzheimer Demonstration Project to provide expanded in-home services to rural Iowans affected by Alzheimer disease and related disorders in 8 rural Iowa counties,randomly selected to have a nurse care manager and 4 designated control counties that had traditional case management service. Nurse care managers were trained in the care of people with dementia and their caregivers, the use of role transition theory, and the Progressively Lowered Stress Threshold model of care to provide and coordinate services for enrollees. All referred people with cognitive impairment and their families in the 8 study counties were eligible for inclusion. Three selected NOC outcomes were tested in clinical settings. Interrater reliability for the outcomes was good (87%,95%). The construct validity of Caregiver Stressors Outcome was .74 when correlated with the Caregiver Stress Index. FINDINGS Of the 142 subjects with cognitive impairment enrolled within the first year of the grant, 113 had a caregiver. The outcomes were used to evaluate differences in caregiver outcomes at baseline and at 6-month intervals. The majority of caregivers at follow-up was female and had been providing care for ,5 years. For each of the outcomes the majority of caregivers had improved scores, with only 2,4 caregivers getting scores indicating worsening conditions or remaining the same. CONCLUSIONS Preliminary analysis shows a trend of improved outcomes with the use of a nurse care manager. The NOC caregiver outcomes showed good variability among caregivers at baseline, with caregiver responses distributed throughout the scales. The NOC outcomes also provide guidance for interventions of the nurse care managers. Further evaluation of the outcomes is needed, including examining the relationships of placement, health status, and service use of each outcome. The caregiver outcomes offer an effective and efficient means to evaluate services delivered to caregivers of people with dementia. [source]

Nurses' perceptions of individualized care

JOURNAL OF ADVANCED NURSING, Issue 5 2010
Riitta Suhonen
suhonen r., gustafsson m.-l., katajisto j., välimäki m. & leino-kilpi h. (2010) Nurses' perceptions of individualized care. Journal of Advanced Nursing,66(5), 1035,1046. Abstract Title.,Nurses' perceptions of individualized care. Aim., This paper is a report of a study of nurses' perceptions of individualized care, the factors associated with these perceptions, and nurses' perceptions of the provision of individualized care in different types of healthcare organization. Background., Although individualized care has been an internationally-challenging and long-standing research topic in nursing, the current literature on individualized care from the perspective of nurses is limited. Methods., A cross-sectional, descriptive and exploratory design using a questionnaire (Individualised Care Scale,Nurse) was employed to survey a stratified sample of 544 nurses (response rate 59%) working as Registered or Enrolled Nurses in one hospital district in Finland in 2008. Data were analysed using descriptive and inferential statistics (General Linear Model, one-way analysis of variance) and Cronbach's alpha coefficients for reliability analysis. Results., Nurses perceived that they supported patient individuality well and that the care they provided took into account patient individuality. Based on the General Linear Model, nurses' background variables were not associated with their perceptions of individualized care delivery. However, between-organization differences were found in all study variables: mental health ward nurses had the most positive perceptions, and nurses working in primary health centre long-term care wards the lowest. Conclusion., Healthcare organizations and work environments need to be evaluated as they may have an influence on individualized care provision. The Individualised Care Nurse instrument is sensitive to healthcare working environments and can be used in evaluating nurses' perceptions of individualized care. [source]

Nurse or physician: whose recommendation influences the decision to take genetic tests more?

JOURNAL OF ADVANCED NURSING, Issue 4 2010
Sivia Barnoy
barnoy s., levy o. & bar-tal y. (2010) Nurse or physician: whose recommendation influences the decision to take genetic tests more? Journal of Advanced Nursing66(4), 806,813. Abstract Title.,Nurse or physician: whose recommendation influences the decision to take genetic tests more? Aim., This paper is a report of a study conducted to explore factors influencing the decision to take genetic carrier testing. Background., Genetic testing has become a popular means of elucidating the risk of giving birth to a sick/disabled child but what influences prospective parents to take genetic tests or not is unclear. Methods., The study was based on a factorial 2 × 2 × 2 within-between subjects design. The questionnaire presented four scenarios, each illustrating a healthcare worker presenting information on a devastating genetic disease. The variables manipulated were: the health care worker's expertise (novice vs. expert), the recommender's role (nurse vs. physician) and type of recommendation (recommendation vs. no recommendation). After each scenario participants were asked their own intention to take the test and their intention to recommend a friend to take the test. Data were collected in 2007. Results., Altogether 156 questionnaires were collected. Expert nurses and expert physicians were accorded the same level of compliance. However, a novice physician's recommendation to take a genetic test was complied with as much as an expert physician's, whereas a novice nurse's recommendation was less accepted than that of an expert nurse. When no recommendation was made, more compliance with the nurse was found (i.e. less intention to take the test). Conclusion., Genetic information should be presented to the public with caution to avoid over-testing. For the public to accept a nurse's recommendation, the nurse has to be perceived as an expert; therefore, expert nurses' proficiency should be made clear. [source]

Hildegard Peplau: Psychiatric Nurse of the Century

JOURNAL OF ADVANCED NURSING, Issue 5 2004
Mary Chambers
No abstract is available for this article. [source]

A Randomized, Controlled Trial of an Intensive Community Nurse,Supported Discharge Program in Preventing Hospital Readmissions of Older Patients with Chronic Lung Disease

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2004
Timothy Kwok FRCP
Objectives: To evaluate the effectiveness of an intensive community nurse (CN)-supported discharge program in preventing hospital readmissions of older patients with chronic lung disease (CLD). Design: Randomized, controlled trial. Setting: Two acute hospitals in the same health region in Hong Kong. Participants: One hundred fifty-seven hospitalized patients aged 60 and older with a primary diagnosis of CLD and at least one hospital admission in the previous 6 months. Intervention: CNs made home visits within 7 days of discharge, then weekly for 4 weeks and monthly until 6 months. CNs coordinated closely with a geriatric or respiratory specialist in hospital. Subjects had telephone access to CNs during normal working hours from Monday to Saturday. Measurements: The primary outcome was the rate of unplanned readmission within 6 months. The secondary outcomes were the rate of unplanned readmission within 28 days, number of unplanned readmissions, hospital bed days, accident and emergency room attendance, functional and psychosocial status, and caregiver burden. Results: One hundred forty hospitalized patients completed the trial. Intervention group subjects had a higher rate of unplanned readmission within 6 months than control group subjects (76% vs 62%, P=.080, ,2 test). There was no significant group difference in any of the secondary outcomes except that intervention group subjects did better on social handicap scores. Conclusion: There was no evidence that an intensive CN-supported discharge program can prevent hospital readmissions in older patients with CLD. [source]

An integrative review and meta-synthesis of the scope and impact of intensive care liaison and outreach services

JOURNAL OF CLINICAL NURSING, Issue 23 2009
Ruth Endacott
Aim., To determine activities and outcomes of intensive care unit Liaison Nurse/Outreach services. The review comprised two stages: (1) integrative review of qualitative and quantitative studies examining intensive care liaison/outreach services in the UK and Australia and (2) meta-synthesis using the Nursing Role Effectiveness Model as an a priori model. Background., Acute ward patients are at risk of adverse events and patients recovering from critical illness are vulnerable to deterioration. Proactive and reactive strategies have been implemented to facilitate timely identification of patients at risk. Design., Systematic review. Methods., A range of data bases was searched from 2000,2008. Studies were eligible for review if they included adults in any setting where intensive care unit Liaison Nurse or Outreach services were provided. From 1423 citations and 65 abstracts, 20 studies met the inclusion criteria. Results., Intensive care liaison/outreach services had a beneficial impact on intensive care mortality, hospital mortality, unplanned intensive care admissions/re-admissions, discharge delay and rates of adverse events. A range of research methods were used; however, it was not possible to conclude unequivocally that the intensive care liaison/outreach service had resulted in improved outcomes. The major unmeasured benefit across all studies was improved communication pathways between critical care and ward staff. Outcomes for nurses in the form of improved confidence, knowledge and critical care skills were identified in qualitative studies but not measured. Conclusion., The varied nature of the intensive care liaison/outreach services reviewed in these studies suggests that they should be treated as bundled interventions, delivering a treatment package of care. Further studies should examine the impact of critical care support on the confidence and skills of ward nurses. Relevance to clinical practice., Advanced nursing roles can improve outcomes for patients who are vulnerable to deterioration. The Nursing Role Effectiveness Model provides a useful framework for evaluating the impact of these roles. [source]

Experience of Hong Kong patients awaiting kidney transplantation in mainland China

JOURNAL OF CLINICAL NURSING, Issue 11c 2007
Sylvie SH Leung MN
Aim., This paper describes the experience of Hong Kong Chinese patients awaiting kidney transplantation in mainland China. Background., While travelling to mainland China for kidney transplantation is a controversial issue, there is an increasing trend of Hong Kong Chinese patients with chronic kidney disease seeking this treatment choice, which outnumbers that performed in Hong Kong. Although these patients seek pre- and post-transplantation care from Hong Kong public healthcare system, little is known about their experience during the waiting period. Methods., This experience is examined in an exploratory qualitative study. In-depth interviews were used to collect data from a purposive sample of 12 kidney recipients. Results., Three major findings are identified: (i) transplant waiting patients may travel to mainland China for transplantation in search of normal life, (ii) they need informational support from their continuing healthcare providers in Hong Kong to make the informed decision and (iii) they perceive a variation of attitudes of nurses and doctors in Hong Kong towards transplantation in mainland China. Conclusions., This study contributes to the literature by researching patients' perspective. The findings highlight the importance and controversy of addressing these patients' informational needs. While the authors have no inclination for or against travelling to mainland China for transplantation, the findings reveal a tenacious clinical dilemma, which deserves debate in international transplant community and further research to inform the debate. Nurse and doctors in Hong Kong may contribute to the debate by articulating their experience of caring for these patients. Relevance to clinical practice., Health information that is readily available for patients scheduled for kidney transplantation in Hong Kong should be made accessible to the whole community of patients with chronic kidney disease. To address the complexity of patients travelling to elsewhere for transplantation and the needs of these patients, provider reticence may be counterproductive. [source]

Nurse discharge planning in the emergency department: a Toowoomba, Australia, study

JOURNAL OF CLINICAL NURSING, Issue 8 2006
Desley Hegney BA
Aim., This study aimed to ascertain whether a model of risk screening carried out by an experienced community nurse was effective in decreasing re-presentations and readmissions and the length of stay of older people presenting to an Australian emergency department. Objectives., The objectives of the study were to (i) identify all older people who presented to the emergency department of an Australian regional hospital; (ii) identify the proportion of re-presentations and readmissions within this cohort of patients; and (iii) risk-screen all older patients and provide referrals when necessary to community services. Design., The study involved the application of a risk screening tool to 2139 men and women over 70 years of age from October 2002 to June 2003. Of these, 1102 (51·5%) were admitted and 246 (11·5%) were re-presentations with the same illness. Patients presenting from Monday to Friday from 08:00 to 16:00 hours were risk-screened face to face in the emergency department. Outside of these hours, but within 72 hours of presentation, risk screening was carried out by telephone if the patient was discharged or within the ward if the patient had been admitted. Results., There was a 16% decrease in the re-presentation rate of people over 70 years of age to the emergency department. Additionally during this time there was a 5·5% decrease in the readmission rate (this decrease did not reach significance). There was a decrease in the average length of stay in hospital from 6·17 days per patient in October 2002 to 5·37 days per patient in June 2003. An unexpected finding was the decrease in re-presentations in people who represented to the emergency department three or more times per month (known as ,frequent flyers'). Conclusions., Risk screening of older people in the emergency department by a specialist community nurse resulted in a decrease of re-presentations to the emergency department. There was some evidence of a decreased length of stay. It is suggested that the decrease in re-presentations was the result of increased referral and use of community services. It appears that the use of a specialist community nurse to undertake risk screening rather than the triage nurse may impact on service utilization. Relevance to clinical practice., It is apparent that older people presenting to the emergency department have complex care needs. Undertaking risk screening using an experienced community nurse to ascertain the correct level of community assistance required and ensuring speedy referral to appropriate community services has positive outcomes for both the hospital and the patient. [source]

Support needs of children's nurses involved in child protection cases

JOURNAL OF NURSING MANAGEMENT, Issue 6 2009
VICKI ROWSE MA
Aim, This qualitative study explored the experiences of nurses working in a hospital paediatric department, who had direct involvement in child protection cases, to discover their support needs and suggest developments in training and support. Background, The study was inspired by an awareness of increasing anxiety amongst nurses involved in child protection cases. Method, A phenomenological approach was used with fifteen nurses during semi-structured interviews, which were taped, transcribed and analysed thematically. Results, Involvement in child protection has a lasting impact; nurses need procedural information from a knowledgeable supporter during a case; and, they need individualized support. The personal qualities of the Named Nurse for Safeguarding Children were crucial. Conclusions, Involvement in child protection cases has lasting effects for individuals. The emotions generated can lead to interagency and inter-professional communication difficulties and affect the future management of child protection by individuals. Seeking support can be hampered by individuals' fear of ridicule or of making a mistake. Implications for nursing management, This study has implications for the training of children's nurses in child protection procedures, and the provision of appropriate effective support for individuals. The long-term effects of involvement are previously unreported by nurses. [source]

New graduate transitions: leaving the nest, joining the flight

JOURNAL OF NURSING MANAGEMENT, Issue 3 2009
ENC(C), PNC(C), SANDRA MORROW RN
Aim, This review will explore the lived experience of the transition of new nursing graduates in their first year of practice, the implications to nursing and consequences of status quo, and actions required to support new graduates in their transition to practice. Background, The new graduate eagerly anticipates their first position in the ,real world' but often experience challenges in their first year of practice. Evaluation, A literature review highlights the historical inaction and the confirmed lived experiences of new graduate nurses. Key issues, New graduate transition into the workforce has implications on both an individual and societal level. No longer can one ignore the need to recruit and retain nurses, especially new graduates. Conclusion, Implemented collaborative and innovative efforts are required to support new graduate nurse transition to practice. Implications for nursing management, Nurse Managers must question why the disenfranchisement and marginalization of new graduates continues. Persistent inertia impacts recruitment and retention of graduate nurses and patient safety, transforming episodic challenges into chronic systemic issues. This article will contribute to new nursing knowledge by providing a Canadian perspective of demographic trends of the Registered Nurse (RN) and salient actions required to resolve the discourse of new graduate transition into the workplace. [source]

Nursing leadership and management effects work environments

JOURNAL OF NURSING MANAGEMENT, Issue 1 2009
ANN MARRINER TOMEY PhD
Aim, The aim of this literature search was to identify recent research related to nursing leadership and management effects on work environment using the 14 forces of magnetism. Background, This article gives some historical perspective from the original 1983 American Academy of Nursing study through to the 2002 McClure and Hinshaw update to 2009 publications. Evaluation, Research publications were given a priority for references. Key issues, The 14 forces of magnetism as identified by Unden and Monarch were: ,1. Quality of leadership,, 2. Organizational structure,, 3. Management style,, 4. Personnel policies and programs,, 5. Professional models of care,, 6. Quality of care,, 7 Quality improvement,, 8. Consultation and resources,, 9. Autonomy,, 10. Community and the hospital,, 11. Nurse as teacher,, 12. Image of nursing,, 13. Interdisciplinary relationships, and 14. Professional development,.'. Conclusions, Correlations have been found among positive workplace management initiatives, style of transformational leadership and participative management; patient-to-nurse ratios; education levels of nurses; quality of patient care, patient satisfaction, employee health and well-being programmes; nurse satisfaction and retention of nurses; healthy workplace environments and healthy patients and personnel. Implications for nursing management, This article identifies some of the research that provides evidence for evidence-based nursing management and leadership practice. [source]

Nurse and resident satisfaction in magnet long-term care organizations: do high involvement approaches matter?

JOURNAL OF NURSING MANAGEMENT, Issue 3 2006
KENT V. RONDEAU PhD
Aim, This study examines the association of high involvement nursing work practices with employer-of-choice (magnet) status in a sample of Canadian nursing homes. Background, In response to a severe shortage of registered nursing personnel, it is imperative for health care organizations to more effectively recruit and retain nursing personnel. Some long-term care organizations are developing employee-centred cultures that allow them to effectively enhance nurse and resident satisfaction. At the same time, many nursing homes have adopted progressive nursing workplace practices (high involvement work practices) that emphasize greater employee empowerment, participation and commitment. Method, A mail survey was sent to the director of nursing in 300 nursing homes in western Canada. In total, 125 useable questionnaires were returned and constituted the data set for this study. Separate ordinary least squares regressions are performed with magnet strength, nurse satisfaction and resident satisfaction used as dependent variables. Results, Nursing homes that demonstrate strong magnet (employer-of-choice) characteristics are more likely to have higher levels of nurse and patient satisfaction, even after controlling for a number of significant factors at the establishment level. Magnet nursing homes are more likely to have progressive participatory decision-making cultures and much more likely to spend considerable resources on job-related training for their nursing staff. The presence of high involvement work practices is not found to be a significant predictor in magnet strength, nurse or resident satisfaction. Conclusion, Merely adopting more high involvement nursing work practices may be insufficient for nursing homes, which desire to become ,employers-of-choice' in their marketplaces, especially if these practices are adopted without a concomitant investment in nurse training or an enhanced commitment to establishing a more democratic and participatory decision-making style involving all nursing staff. [source]

Practice development: a concept analysis

JOURNAL OF NURSING MANAGEMENT, Issue 6 2000
BSc (Hons), J. Unsworth MSc
Aims This analysis sets out to explore the nature and scope of the concept of practice development. Background The last 10 years has seen a growing interest in the development of health care practice. However, the exact nature of practice development remains poorly articulated and nebulous. Literature from nursing, medical, accountancy, social work and counselling is used to identify the critical attributes of the concept. Data analysis The analysis uses the techniques developed by Walker & Avant (1995) to collect information on the use of the concept from the literature and to construct cases. Key issues Many of the attributes of practice development are shared by other related concepts such as innovation. However, four critical attributes of practice development were identified and illustrated through case construction. Conclusions An understanding of the nature and scope of practice development is essential if the role of the Practice Development Nurse is to be evaluated. The critical attributes and empirical referents identified in this analysis provide a framework for both role development and evaluation. [source]

The Development of Advanced Nursing Practice Globally

JOURNAL OF NURSING SCHOLARSHIP, Issue 3 2008
Barbara Sheer
Purpose: To examine the development of advanced nursing practice globally. Methods: Data were collected from documentary resources available in the International Nurse Practitioners/Advanced Practice Nurse Network (INP/APNN) of the International Council of Nurses. The areas examined were guided by the "key informant survey on advanced nursing practice self-administered questionnaire." Two core members of the INP/APNN who have rich experience in global advanced nursing development analyzed the data. A total of 14 countries and three regions from five continents were included in the analyses. The development of advanced nursing practice in these areas is facilitated by a need for better access to care in a cost-containment era and the enhancement of nursing education to postgraduate level. The mechanism for regulation of practice is in place in some countries. Conclusions: Confirms the development of advanced practice in nursing is a global trend. Clinical Relevance: APNs can improve global health with points to enhanced education in nursing and regulation of advanced practice. [source]

Patient Problems, Advanced Practice Nurse (APN) Interventions, Time and Contacts Among Five Patient Groups

JOURNAL OF NURSING SCHOLARSHIP, Issue 1 2003
Dorothy Brooten
Purpose: To describe patient problems and APN interventions in each of five clinical trials and to establish links among patient problems, APN interventions, APN time and number of contacts, patient outcomes, and health care costs. Design and Methods: Analysis of 333 interaction logs created by APNs during five randomized controlled trials: (a) very low birthweight infants (n=39); (b) women with unplanned cesarean birth (n=61), (c) high-risk pregnancy (n=44), and (d) hysterectomy (n=53); and (e) elders with cardiac medical and surgical diagnoses (n=139). Logs containing recordings of all APN interactions with participants, APN time and type of patient contact were content analyzed with the smallest phrase or sentence representing a "unit." These units were then classified using the Omaha Classification System to determine patient problems and APN interventions. Groups were compared concerning total amount of APN time, number of contacts per patient, and mean length of time per APN contact. All studies were conducted in the United States. Findings: Groups with greater mean APN time and contacts per patient had greater improvements in patients' outcomes and greater health care cost savings. Of the 150,131 APN interventions, surveillance was the predominant APN function in all five patient groups. Health teaching, guidance, and counseling was the second most frequent category of APN intervention in four of the five groups. In all five groups, treatments and procedures accounted for < 1% of total APN interventions. Distribution of patient problems (N=150,131) differed across groups reflecting the health care problems common to the group. Conclusions: Dose of APN time and contacts makes a difference in improving patient outcomes and reducing health care costs. Skills needed by APNs in providing transitional care include well-developed skills in assessing, teaching, counseling, communicating, collaborating, knowing health behaviors, negotiating systems, and having condition-specific knowledge about different patient problems. [source]

Why Wouldn't You Become a Nurse?

JOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 6 2005
Nancy K. Lowe Editor
No abstract is available for this article. [source]

Nurse prescribing in mental health: national survey

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 6 2010
D. DOBEL-OBER phd
Accessible summary ,,Nurse prescribing has grown relatively slowly in mental health care since it was introduced in early 2000s. ,,This paper reports findings from a survey of directors of nursing in England. ,,It provides information about the current level of development of nurse prescribing and about intentions with regards to future implementation and development. Abstract Mental health nurses can now train to become independent prescribers as well as supplementary prescribers. Independent nurse prescribing can potentially help to reorganize mental health services, increase access to medicines and improve service user information, satisfaction and concordance. However, mental health nursing has been slow to undertake prescribing roles, and there has been little work conducted to look at where nurse prescribing is proving successful, and those areas where it is less so. This survey was designed to collect information from directors of nursing in mental health trusts about the numbers of mental health prescribers in England, gather views about prescribing in practice, and elicit intentions with regards to the development of nurse prescribing. In some Trusts, the number of mental health nurse prescribers has increased to the point where wider impacts on workforce, the configuration of teams and services are inevitable. Currently, the way that prescribing is used within different organizations, services and teams varies and it is unclear which setting is most appropriate for the different modes of prescribing. Future work should focus on the impact of mental health nurse prescribing on service delivery, as well as on service users, colleagues and nurses themselves. [source]

Evaluation of a community-based mental health drug and alcohol nurse in the care of people living with HIV/AIDS

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2009
J. ALLEN rn ba (hons) m psych (counselling psychology)
There is a growing need for advanced practice mental health and drug and alcohol nursing roles in the care of people living with HIV/AIDS; however, limited publications address these domains. This study evaluated a community-based mental health drug and alcohol nurse role caring for people living with HIV/AIDS (Mental Health D&A Nurse) in a large not-for-profit district nursing organization providing care to people living with HIV/AIDS in an Australian city. Outcomes from a client assessment and 6,8-week follow-up by the Mental Health D&A Nurse are presented as captured by the Depression Anxiety Stress Scales (DASS 21), Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Health of the Nation Outcome Scales (HONOS) and WHOQoL BREF. Mean scores and caseness were analysed, and significant differences were found on the ,impairment' and ,social problems' subscales of the HONOS. Results of semi-structured interviews with clients describe effective and supportive mental health care and health-promoting education following visits by the Mental Health D&A Nurse. These positive findings support continuing implementation of the role within this community setting and indicate that even greater benefits will ensue as the role develops further. Findings are of interest to clinicians and policy makers seeking to implement similar roles in community-based HIV/AIDS care. [source]

Reflections on the process of change on acute psychiatric wards during the City Nurse Project

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2006
C. FLOOD rn
The intention of this paper is to discuss the process of therapeutic change on two acute psychiatric wards during a research project that aimed to reduce conflict and containment. Analysis of fieldwork notes, reflection, team discussion and supervision. The City Nurse Project successfully reduced patient aggression, self-harm and absconding. This paper reports on the reflections made over the course of the year as changes and developments to acute wards took place. Specifically discussed are the beneficial effects of an action research approach, the role of the City Nurse, support for ward managers, education and training, clinical supervision as well as difficulties and barriers to the overall process of change. At an interim stage of the project, the staff have shown a willingness to engage in efforts to change and improve two acute wards. This paper shows the potential to improve acute wards and produce positive outcomes using a working model. [source]

Nurse,client processes in mental health: recipients' perspectives

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2006
R. COATSWORTH-PUSPOKY rn mscn
An ethnonursing method was selected to explore and describe nursing support relationships, from the perspectives of recipients, within the mental health subculture. Data sources consisted of three semi-structured client interviews (n = 14) and field notes. When nurses were described as nice and friendly, and validated the client as a person by listening, three overlapping phases of development emerged from the data. These included: a glimmer of help, exploring and problem solving, and saying goodbye. When clients had negative experiences with nurses, they felt a lack of trust towards nurses and felt that their feelings were left unexplored. As a result, the relationships deteriorated. Deterioration began immediately in the first phase called withholding, and continued through the phases of avoiding and ignoring, and struggling with and making sense of. These findings raise healthcare providers' awareness about developing and deteriorating nurse,client relationships, and support the value of the therapeutic relationship as an instrument to restore and promote clients' health. [source]

Sports Medicine and School Nurses: A Growing Need for Further Education and Appropriate Resources

JOURNAL OF SCHOOL HEALTH, Issue 1 2006
Cynthia S. Knight
The use of exercise as a prerequisite for conditioning and proper treatment of injuries was first documented in early Greek civilization with the establishment of the Olympics. Today, sports by their very nature invite injury. In 2000, 2.5 million students participated in varsity sports with 750,000 injuries recorded. These numbers do not account for sports activities outside school or leisure activities. Another area of potential injury is physical education class. These classes are large with limited supervision and encompass students of varying age and abilities. Nurses do not have an extensive knowledge of injury prevention or assessment in their basic nursing education. School nurses, as a subspecialty within nursing, are expected to keep up with the requirements of the adolescent and pediatric populations as well basic nursing skills. Due to work schedules and limited resources for continuing education, school nurses are not afforded much time or benefits to attend classes that would teach them skills needed to assess athletic-type injuries. School nurses need printed resources specific to their setting to help fill this void. Recognizing this need, Sports Medicine Techniques for the School-Based Nurse is a manual in process that will help fill this void. Being developed specifically for school nurses, the manual will provide information on prevention, evaluation, and management of athletic-type injuries commonly seen in the school nurse's office. (J Sch Health. 2006;76(1):8-11) [source]