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Nursing Actions (nursing + action)
Selected Abstracts,The real stuff': implications for nursing of assessing and measuring a terminally ill person's quality of lifeJOURNAL OF CLINICAL NURSING, Issue 6 2001BN(Ed), Merilyn Annells Dip AppSc ,,Two quality of life (QoL) assessment and measurement tools, the Client Generated Index (CGI) and the McGill Quality of Life (MQOL) questionnaires, were trialled within district nursing palliative care to test usefulness and feasibility for holistic intervention selection, individualized palliative care planning, and measurement of the quality of dying. ,,The specific focus of this paper is to discuss the less tangible outcomes of the trial, which illuminate the partly ,hidden' value and nature of clinical nursing. ,,These outcomes include awareness that the use of such tools may: by actual administration of the tool be, in and of itself, a therapeutic nursing action; focus on ,the real stuff' from the client's perspective, that which matters most to the terminally ill client, but may not be classically considered as prompting nursing intervention; and facilitate ,the real stuff' of nursing, perhaps known but not usually articulated by nurses, and which usually does not feature on care plans nor in time allocation schedules. [source] Physical and chemical restraints in acute care: Their potential impact on the rehabilitation of older peopleINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 3 2005Sarah Mott RN PhD FRCNA Agitation is a major problem for older people and is present in over half of the hospitalizations for people > 65 years of age. In a previous study by the authors, results indicated that nursing actions often did not meet best-practice standards in the care of older, agitated patients. This paper builds on these results by reviewing the literature pertaining to the use of restraints and contributes to the body of knowledge surrounding the impact of the acute-care experience on rehabilitation outcomes. Successful rehabilitation relies on the improvement of functional health outcomes and, for this to happen, physical and emotional well-being are important. The sequelae of restraint use in acute care have the potential to alter peoples' ability to participate fully in a rehabilitation programme, thereby placing their future placement at risk. This paper explores the outcomes of restraint use in the acute-care setting and presents the argument that their effects are likely to be detrimental to rehabilitation outcomes. [source] Nursing management of fever in children: A systematic reviewINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 1 2003FRCNA, Robin Watts RN ABSTRACT Objectives:, The aim of the present review was to determine whether the best available evidence supports the types and timing of the various nursing interventions that are commonly used to reduce fever in non-critically-ill children, and to what extent the outcomes are influenced by these nursing actions. Methods:, Studies included were randomised or quasi-randomised controlled trials that involved non-critically-ill children with a fever aged between 3 months and 16 years. ,,The search strategy sought to identify both published and unpublished research reports in the English language and covered all major databases up to 1998. ,,The methodological quality of each study was assessed by two independent reviewers using a piloted critical appraisal checklist. ,,Despite all studies being randomised, heterogeneity precluded conduction of a meta-analysis; therefore, evidence was synthesised using narrative summaries. Results: Ten studies were assessed as being of sufficient quality to be included in the review. These studies addressed two of the intervention categories identified in the protocol: (i) administration of antipyretics (paracetamol); and (ii) direct cooling measures on the outcome measure (reduction of or prevention of increase in fever). The review found little benefit from sponging in temperate climates and usually at the expense of the child's comfort. There may be situations in high environmental temperatures and high humidity, or where there is a need for immediate temperature reduction, in which sponging may be warranted. Risks were identified when paracetamol was administered on a sustained basis over even a short period of time and above a relatively low total daily dosage. There was a lack of evidence to support the administration of antipyretics to reduce the incidence of febrile convulsions. There is a need for parental education that focuses on knowledge of the body's protective physiological responses and how to support these responses. Conclusion: The primary purpose for intervening when a child has a fever is to increase the child's comfort. This consideration should be weighed against any harm that might result from intervening. There was a lack of evidence to support the routine use of sponging. The administration of paracetamol should be used selectively and with caution. In summary, care needs to be individualised, based on current knowledge of the effectiveness and risks of interventions. [source] Is It Time for a New Category of Nursing Diagnosis?INTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2 2007Geralyn A. Meyer PhD Professional vigilance, the art of "watching out," is the essence of nursing. Vigilance is the mental process that makes the informed nursing actions of assessment, diagnosis, intervention, and evaluation possible and meaningful. Nursing vigilance must be described in our nursing terminology or it risks remaining invisible to others. We propose that the current definition of nursing diagnosis be expanded to include surveillance diagnoses for which the nurse has the responsibility for problem identification and ongoing monitoring. Inclusion of surveillance diagnoses in the NANDA International taxonomy will better reflect the breadth and depth of nursing practice. [source] Community health nurses in action: a case study from JordanINTERNATIONAL NURSING REVIEW, Issue 2 2007K. Shishani phd Community health nurses can make a considerable difference in the lives of disadvantaged population groups. One of their major roles is to conduct studies that focus on at-risk populations and to use the findings to implement nursing actions to promote the public's health. This case study describes one such activity in Jordan. [source] Nursing practice and oral fluid intake of older people with dementiaJOURNAL OF CLINICAL NURSING, Issue 21 2008Sandra Ullrich Aim., This paper describes the findings of a descriptive study about what nurses do to ensure that older people with dementia have adequate hydration. Background., Frail nursing home residents, particularly those who cannot accurately communicate their thirst as a result of Alzheimer's disease and who depend on nursing staff for their fluid intake, are at risk of dehydration. While the interventions that promote nutrition in older people with dementia are documented, the specific interventions for improving oral hydration in older people with dementia remain poorly studied and understood. Design., Observational study. Methods., Ten care workers and seven residents were observed for the types of behavioural nursing interventions and assistance provided to residents when promoting oral fluid intake. Observational data were compared with resident-care plans to determine whether what was carried out by care workers was consistent with what was being documented. Results., Care workers provided a wide variety of behavioural interventions to the residents when promoting oral fluid intake. The resident-care plans did not sufficiently represent the specific interventions implemented by care workers. Conclusions., A more rigorous approach is required in defining the specific behavioural interactions practised by care workers, which promote oral fluid intake in older people with dementia. Nurses determined the content of care documented in care plans, yet they were not the predominant implementers of that care. Care plans need to be accurate in terms of the specific nursing actions that respond to the level of assistance required by the resident, both behaviourally and physically. Relevance to clinical practice., Sound knowledge and reflective practices should be implemented by care workers of the nursing interventions that promote adequate oral fluid intake. Care plans should serve a dual purpose and facilitate communication between staff members and provide sufficient flexibility to allow for the contribution of novel ways in which to promote oral fluid intake while also being educative. [source] How do nurses record pedagogical activities?JOURNAL OF CLINICAL NURSING, Issue 10 2007Nurses' documentation in patient records in a cardiac rehabilitation unit for patients who have undergone coronary artery bypass surgery Aims., To describe the use of pedagogically related keywords and the content of notes connected to these keywords, as they appear in nursing records in a coronary artery bypass graft (CABG) surgery rehabilitation unit. Background., Nursing documentation is an important component of clinical practice and is regulated by law in Sweden. Studies have been carried out in order to evaluate the educational and rehabilitative needs of patients following CABG surgery but, as yet, no study has contained an in-depth evaluation of how nurses document pedagogical activities in the records of these patients. Methods., The records of 265 patients admitted to a rehabilitation unit following CABG surgery were analysed. The records were structured in accordance with the VIPS model. Using this model, pedagogically related keywords: communication, cognition/development and information/education were selected. The analysis of the data consisted of three parts: the frequency with which pedagogically related keywords are used, the content and the structure of the notes. Results., Apart from the term ,communication', pedagogically related keywords were seldom used. Communication appeared in all records describing limitations, although no explicit reference was made to pedagogical activities. The notes related to cognition/development were grouped into the following themes: nurses' actions, assessment of knowledge and provision of information, advice and instructions as well as patients' wishes and experiences. The themes related to information were the provision of information and advice in addition to relevant nursing actions. The structure of the documentation was simple. Conclusions., The documentation of pedagogical activities in nursing records was infrequent and inadequate. Relevance to clinical practice., The patients' need for knowledge and the nurses' teaching must be documented in the patient records so as to clearly reflect the frequency and quality of pedagogical activities. [source] Hand hygiene among nurses in Turkey: opinions and practicesJOURNAL OF CLINICAL NURSING, Issue 3 2007Asiye D. Akyol RN Aims and objectives., This study aims to identify nurses' practices and opinions of handwashing during routine patient care. Background., Transmission of microorganisms from the hands of healthcare workers is the main source of cross-infection in hospitals and can be prevented by handwashing. Design and methods., A questionnaire survey was used for this study. A total of 129 clinical nurses at University of Ege Faculty of Medicine Application and Investigation Hospital at Internal Medicine Clinics was surveyed with a response rate of 100%. Data analysis was carried out using SPSS version 10. Results., The study revealed that nurses have a poor level of knowledge concerning quality of hand washing. All nursing actions related to ,clean' and ,dirty' activities were evaluated using the Fulkerson scale. The majority of nurses reported that they always wash hands after contact with contaminated and non-contaminated patients, equipment and environment. It was found that they did need to wash their hands often but that they were not able to do this because of dense working conditions, insufficiency of necessary materials and drying and sore of hands after frequent washing. Conclusion., To improve hand hygiene and quality of handwashing compliance, additional factors must be considered. These factors include improving healthcare workers , especially nurses', skin conditions, hand hygiene techniques and disinfections substantially. Relevance to clinical practice., Hospitals need to develop and implement innovative educational and motivational programmes tailored to specific groups of health personnel. [source] | ||||||||||