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Nursing Assessment (nursing + assessment)
Selected AbstractsUtilization of the Ottawa Ankle Rules by Nurses in a Pediatric Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 2 2002Anna Karpas MD Objectives: To determine the ability of pediatric emergency department (ED) nurses to accurately apply the Ottawa Ankle Rules (OAR) and to evaluate whether the rate of negative ankle radiographs can be reduced by incorporating the OAR into an existing collaborative practice protocol (CPP). Methods: The authors' ED currently uses a CPP in which patients with ankle pain, swelling, deformity, or decreased range of motion on primary nursing assessment undergo radiography prior to physician evaluation. A cross-sectional study was conducted between June and November 2000. Patients aged 5-19 years with an ankle injury who met at least one of the CPP criteria were eligible for enrollment. The OAR were applied by the primary nurse after initial assessment. Ankle radiographs were ordered for all enrolled patients. The interobserver variability between nurses was evaluated on a random sample. Results: One hundred ninety subjects were enrolled in the study. The OAR were correctly interpreted by nurses in 98.4% of subjects. Agreement on the interobserver reliability sample was 100%. Of the 185 subjects, 31 (16.8%) had positive radiographs. Positive OAR results were noted in 30 of 31 subjects with positive radiographs. The sensitivity of the OAR was 97% (95% CI = 0.82 to 0.99) with a specificity of 25% (95% CI = 0.18 to 032). Use of the OAR would have reduced the radiography rate by 21%. Conclusions: Trained nurses can accurately apply and interpret the OAR. The incorporation of the OAR into the nursing assessment of children with acute ankle injuries may reduce the number of radiographs ordered. [source] Symptom burden in inflammatory bowel disease: Rethinking conceptual and theoretical underpinningsINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 5 2010Dawn Farrell BSC RGN Farrell D, Savage E. International Journal of Nursing Practice 2010; 16: 437,442 Symptom burden in inflammatory bowel disease: Rethinking conceptual and theoretical underpinnings Symptom control is fundamental to the nursing management of inflammatory bowel disease (IBD). However, symptom control can be problematic for individuals with IBD, which could result in symptom burden. Symptom burden is an evolving concept in the discipline of nursing and to date little is known about how the defining characteristics of this concept have been applied to symptom research in IBD. In this discussion paper, the concept of symptom burden and the theory of unpleasant symptoms are explored as a basis for understanding symptom research in IBD. This is followed by a critical examination of previous symptom research in IBD. Our conclusion is that there is a need to rethink conceptual and theoretical underpinnings of symptom burden when researching IBD to take account of its defining characteristics, namely symptom severity, frequency and duration, quality and distress. Research knowledge on these defining characteristics will be important to inform nursing assessment of symptom burden in clinical practice. [source] Rapid Emergency Department Intervention for Older People Reduces Risk of Functional Decline: Results of a Multicenter Randomized TrialJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2001DrPH, Jane McCusker MD OBJECTIVES: To determine the effectiveness of a two-stage (screening and nursing assessment) intervention for older patients in the emergency department (ED) who are at increased risk of functional decline and other adverse outcomes. DESIGN: Controlled trial, randomized by day of ED visit, with follow-up at 1 and 4 months. SETTING: Four university-affiliated hospitals in Montreal. PARTICIPANTS: Patients age 65 and older expected to be released from the ED to the community with a score of 2 or more on the Identification of Seniors At Risk (ISAR) screening tool and their primary family caregivers. One hundred seventy-eight were randomized to the intervention, 210 to usual care. INTERVENTION: The intervention consisted of disclosure of results of the ISAR screen, a brief standardized nursing assessment in the ED, notification of the primary care physician and home care providers, and other referrals as needed. The control group received usual care, without disclosure of the screening result. MEASUREMENTS: Patient outcomes assessed at 4 months after enrollment included functional decline (increased dependence on the Older American Resources and Services activities of daily living scale or death) and depressive symptoms (as assessed by the short Geriatric Depression Scale). Caregiver outcomes, also assessed at baseline and 4 months, included the physical and mental summary scales of the Medical Outcomes Study Short Form-36. Patient and caregiver satisfaction with care were assessed 1 month after enrollment. RESULTS: The intervention increased the rate of referral to the primary care physician and to home care services. The intervention was associated with a significantly reduced rate of functional decline at 4 months, in both unadjusted (odds ratio (OR) = 0.60, 95% confidence interval (CI) = 0.36,0.99) and adjusted (OR = 0.53, 95% CI = 0.31,0.91) analyses. There was no intervention effect on patient depressive symptoms, caregiver outcomes, or satisfaction with care. CONCLUSION: A two-stage ED intervention, consisting of screening with the ISAR tool followed by a brief, standardized nursing assessment and referral to primary and home care services, significantly reduced the rate of subsequent functional decline. J Am Geriatr Soc 49:1272,1281, 2001. [source] An exploratory study of web-enhanced learning in undergraduate nurse educationJOURNAL OF CLINICAL NURSING, Issue 12 2007BSc (Hons), Elizabeth A Mitchell MSc, PG Dip Ed Aim.,The aim of the study was to explore undergraduate nursing students' views of web-enhanced learning and to examine issues relating to their pattern of access to a rehabilitation nursing module website. Background.,As information technology is an integral component of western health care, all nurses are expected to have the necessary knowledge, skills and attitudes to be competent in its use. Methods.,In phase 1, a focus group interview was conducted with students (n = 6) who had not logged onto a similar module website. In phase 2, a questionnaire was administered to students undertaking the web-enhanced module. In phase 3, each student's (n = 231) pattern of access to the module was identified and compared with the student's performance as evidenced by their module assignment mark. Results.,Students held favourable attitudes towards web-enhanced learning but some students experienced difficulties. There was a significant positive association between the students' assignment mark and the number of times logged onto the module website. Significant negative correlations were found between mark and week of first log on, and week of first log on and number of hits onto the module site. This suggests that students who logged onto the module in the first few weeks were more likely to achieve higher marks. Conclusions.,This study's findings suggest that students who accessed the module website early and often were more likely to produce more comprehensive nursing assessments and consequently achieve higher assignment marks than their colleagues. Relevance to clinical practice.,The findings have relevance to all nurses as lifelong learning is a mandatory requirement for maintaining clinical competence and electronic learning can provide students (regardless of registration status) with the flexibility to gain access to course content at a time and place convenient to them. The role of electronic learning in promoting a more holistic nursing assessment is also discussed. [source] An exploration of the contribution of the community nurse to rehabilitationHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 4 2003Rosie Kneafsey RGN BSc Abstract Effective hospital and community rehabilitation services are increasingly recognised as a means of meeting the changing pattern of health and social care need. While the district or community nurse has the potential to play a central part in community rehabilitation provision, this role has received relatively scant attention in the literature. This paper describes research findings on community nurses' perceptions of their role and potential contribution to rehabilitation. As part of a wider, 2-year, qualitative investigation of the role of the nurse in rehabilitation, fieldwork was undertaken with both district and community staff nurses. This comprised focus group discussions and interviews with staff recruited as a consequence of the follow-up of patients' experiencing rehabilitation. The findings indicate that community-based nurses contributed to patient rehabilitation by making assessments, referring on to other members of the multi-professional team, advocating for and liaising with other services, helping people to adapt, teaching and motivating patients and carers, supporting and involving families, and providing technical care. A number of challenges to community-based nursing roles were apparent, including feelings of exclusion, lack of recognition, a lack of time for rehabilitation and paucity of referrals for rehabilitation. Greater clarity and recognition is needed of the community-based nursing contribution to rehabilitation, and there is a need to ensure that community nursing assessments contribute to patients' rehabilitation goals and the promotion of independent living. [source] An exploratory study of web-enhanced learning in undergraduate nurse educationJOURNAL OF CLINICAL NURSING, Issue 12 2007BSc (Hons), Elizabeth A Mitchell MSc, PG Dip Ed Aim.,The aim of the study was to explore undergraduate nursing students' views of web-enhanced learning and to examine issues relating to their pattern of access to a rehabilitation nursing module website. Background.,As information technology is an integral component of western health care, all nurses are expected to have the necessary knowledge, skills and attitudes to be competent in its use. Methods.,In phase 1, a focus group interview was conducted with students (n = 6) who had not logged onto a similar module website. In phase 2, a questionnaire was administered to students undertaking the web-enhanced module. In phase 3, each student's (n = 231) pattern of access to the module was identified and compared with the student's performance as evidenced by their module assignment mark. Results.,Students held favourable attitudes towards web-enhanced learning but some students experienced difficulties. There was a significant positive association between the students' assignment mark and the number of times logged onto the module website. Significant negative correlations were found between mark and week of first log on, and week of first log on and number of hits onto the module site. This suggests that students who logged onto the module in the first few weeks were more likely to achieve higher marks. Conclusions.,This study's findings suggest that students who accessed the module website early and often were more likely to produce more comprehensive nursing assessments and consequently achieve higher assignment marks than their colleagues. Relevance to clinical practice.,The findings have relevance to all nurses as lifelong learning is a mandatory requirement for maintaining clinical competence and electronic learning can provide students (regardless of registration status) with the flexibility to gain access to course content at a time and place convenient to them. The role of electronic learning in promoting a more holistic nursing assessment is also discussed. [source] Clinical formulation for mental health nursing practiceJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 10 2008M. Crowe rn phd There are problems for mental health nurses in using psychiatric diagnoses as outcomes of their nursing assessments and nursing diagnoses present similar issues. However, there is a need in practice to link the assessment to nursing interventions in a meaningful way. This paper proposes that the clinical formulation can be regarded as central to providing this cohesion. The formulation does not merely organize the assessment findings but is also an interpretation or explanation, made in consultation with the client, of what meaning can be attributed to the issues explored in the assessment process. Because this interpretation is dependent on both the client's and the nurse's explanatory frameworks, there are multiple ways of developing the formulation. It is also an evolving and dynamic statement of understanding. A case example is provided in the paper to illustrate how the same case can be interpreted in different ways and the implications this has for the nursing interventions provided. [source] | ||||||||||