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Practice Development (practice + development)
Terms modified by Practice Development Selected AbstractsDIABETES AUDIT CAN AID PRACTICE DEVELOPMENT IN A RANGE OF INDIGENOUS HEALTH CARE SETTINGSAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 5 2001Nadia Chaves No abstract is available for this article. [source] Magnet Recognition and Practice Development: Two journeys towards practice improvement in health careINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 6 2009Zoe Jordan BA MA (Communications Studies) Health service providers continue to struggle with recruitment, retention, evidence-based practice and practice improvement in order to provide high-quality care for the communities they serve. In doing so, they are often required to implement strategies, which require considerable change at both organizational and ward/unit levels. The question remains, how do health service providers instigate processes that will result in positive and sustainable changes to practice and better outcomes for staff and patients? This paper outlines two increasingly used strategies for practice improvement (namely Magnet Recognition and Practice Development), their points of convergence and divergence and makes some broad recommendations for those seeking effective strategies for change that are cognizant of context and culture. [source] Practice Development and AuditINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue S3 2008Article first published online: 18 FEB 2010 First page of article [source] Practice development , Part 2: evaluating a practice initiativeEUROPEAN JOURNAL OF CANCER CARE, Issue 3 2007G.G. DARK mbbs, iltm No abstract is available for this article. [source] Practice development , Part 1: developing a practice initiative in oncology and palliative careEUROPEAN JOURNAL OF CANCER CARE, Issue 2 2007G.G. DARK mbbs, iltm No abstract is available for this article. [source] Editorial: Practice development: ,to be what we want to be'JOURNAL OF CLINICAL NURSING, Issue 2 2009Brendan McCormack [source] The experience of practice development: an exploratory telephone interview studyJOURNAL OF CLINICAL NURSING, Issue 1 2001Rob Garbett MSc , ,Practice development is a widely used term within British nursing. However, there is a lack of consistency and clarity in the way that the term is used. , ,A small-scale qualitative telephone interview study was therefore conceived to explore practitioners' views of practice development. , ,Qualitative telephone interviews were carried out with 26 nurses working in a range of settings and roles around the UK. Informants reported varying degrees of awareness of practice development roles and activities ranging from little awareness to being closely involved. , ,Most informants seemed to place more emphasis on issues of personal development and educational aspects of practice development than is found in the literature. , ,Practice development staff were seen as having a range of functions ranging from working with individual practitioners to the co-ordination of education and training within an organization. The credibility of practice development staff was closely related to their clinical experience and ability. [source] Practice development: a concept analysisJOURNAL OF NURSING MANAGEMENT, Issue 6 2000BSc (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] Recovering from the psychological impact of intensive care: how constructing a story helpsNURSING IN CRITICAL CARE, Issue 6 2009Susan Lecky Williams ABSTRACT Background: Numerous studies have demonstrated both the risk of post-traumatic stress as a result of intensive care unit (ICU) treatment and the efficacy of successful narrative processing for recovery from psychological trauma. Aim: This article is based on recent doctoral research exploring the impact of unanticipated life threats after admission to hospital. It examines the difficulties ICU patients have with constructing coherent narratives of their illness experience and the significance of those difficulties for psychological recovery from critical illness. Methods: The original research used a qualitative design blending discourse, narrative, and phenomenological approaches guided by hermeneutical sensitivity to the evolving language of narrative processing. Patients chosen from ICU discharge summaries showing a critical life-threatening event after admission to hospital were interviewed soon after discharge from hospital and then again 1 year later. Unstructured interviews explored participant experience of a critical event and its aftermath. Results: This article focuses in particular on one finding from the doctoral research. Unanticipated critical illness presented some patients with difficulties in accomplishing the fundamental human task of constructing a narrative of their experience. Risk factors were observed identifying specific vulnerabilities. The extent to which difficulties were overcome impacted positively on the patient's sense of well-being 1 year after discharge. Conclusions: In order to recover psychologically, some ICU patients need help overcoming obstacles to their ability to construct an adequately coherent narrative of their experience. Relevance to clinical practice: ICU follow-up clinics could gain increased clarity of purpose from this narrative conceptual framework, eventually evaluating and validating benchmarks for assessing psychological recovery in relation to specified dimensions of narrative processing. Practice development informed by narrative process theory could also enhance ICU nursing communication. Since story construction is central to a person's core identity processes, person-centred nursing would also be implicated. [source] Practice development: purpose, methodology, facilitation and evaluationNURSING IN CRITICAL CARE, Issue 1 2003Kim Manley Summary ,Different approaches to practice development are associated with different assumptions, and these need to be made explicit if practice development is to be transparent, rigorous and systematic in its intentions and approaches ,A practice development methodology underpinned by critical social science is advocated because it focuses on achieving sustainable change through practitioner enlightenment, empowerment and emancipation and an associated culture, rather than focusing only on technical practice development ,Implications of different worldviews about practice development for facilitation and outcome evaluation are highlighted ,Emancipatory practice development underpinned by critical social science is argued as synonymous to emancipatory action research [source] Facilitating collaborative development in practiceINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 5 2009Debbie Tolson PhD MSc BSc RGN The promotion of stakeholder partnerships features within practice development work and is intuitively appealing, but in reality meaningful partnerships can be problematic. We report the findings of four parallel Nominal group Technique Interviews undertaken with groups of professional (nurses from practice and academia) and lay stakeholder representatives during a seminar event. The group work sought to explore the mechanisms, which could facilitate meaningful practice development partnerships between nurses, academic nurses and people. The most highly ranked suggestions included creating a culture where practice development is seen as everyone's business and establishing a unified collaborative infrastructure. A range of enabling and inhibiting conditions were explored and the complexity of achieving consensus decision-making processes that would allow realization of the policy rhetoric was exposed. [source] Explicating Benner's concept of expert practice: intuition in emergency nursingJOURNAL OF ADVANCED NURSING, Issue 4 2008Joy Lyneham Abstract Title.,Explicating Benner's concept of expert practice: intuition in emergency nursing. Aim., This paper is a report of a study exploring the experience of intuition in emergency nursing in relation to Benner's fifth stage of practice development, ,the expert practitioner.' Background., Expert nurses anecdotally report actions and thoughts that present in their consciousness and have an impact on the care given. Benner used the term ,intuition' for the fifth stage of practice development. However, Paley has criticized Benner's model for its lack of clarity about the nature of an expert practitioner. This criticism is further justified by Benner's inadequate explanation of expert. Method., A hermeneutic phenomenological study was conducted using van Manen's approach and a Gadamerian analysis. Fourteen expert emergency nurses in Australia were interviewed between January 2000 and December 2003. Findings., The analysis resulted in the reconstruction of Benner's expert stage into three distinct phases: cognitive intuition, where assessment is processed subconsciously and can be rationalized in hindsight; transitional intuition, where a physical sensation and other behaviours enter the nurse's awareness; and embodied intuition, when the nurse trusts the intuitive thoughts. Conclusion., The findings validate the use of intuitive decision-making as a construct in explaining expert clinical decision-making practices. The validity of intuitive practice should be recognized. It is essential to recognize the conditions that support practice development, and in the prenovice stage (during their university course) factors such as reflection, research (in its broadest sense) and clinical curiosity should be fostered. [source] Stoma coloproctology nurse specialist: a case studyJOURNAL OF CLINICAL NURSING, Issue 6 2007Ursula Chaney DPSN Aims and objectives., The aim of this paper is to provide insight into the role of a Stoma Coloproctology Nurse Specialist. This paper presents the findings of an in-depth case study of a stoma coloproctology nurse specialist employed in one health board area in Northern Ireland. This case study was part of a larger study exploring innovative nursing and midwifery roles in Northern Ireland. Background., Specialist nursing roles have evolved and developed in response to changing health care needs, patient expectations, changes in professional regulation and government initiatives. Design., A case study approach was adopted. Method., Semi-structured interviews with the post holder (PH), her line manager and the human resource manager were undertaken. Non-participant observation of the PH's practice was also carried out. Analysis was undertaken on secondary data such as job specification, annual reports and other documentation relating to the post. Results., Findings illustrate the PH's function and the impact of the role on patient care. Examples of innovative practices relating to providing care, support and guidance for patients and their families were identified; however, limitations to her role were also identified. Conclusions., The PH provides an invaluable service to patients, demonstrating a positive impact on care. However, the findings suggest the importance of establishing clear role boundaries, which may lead to professional growth and practice development. Relevance to clinical practice., Although this study provides a valuable insight into the role of a Stoma Coloproctology Nurse Specialist a number of challenges exist, as the CNS role requires policy and appropriate educational preparation to practice at an advanced level. Further research investigating the development of the CNS role in the clinical setting and its relationship to members of the multi-professional team would be beneficial. [source] Community mental health nursing and early intervention in dementia: developing practice through a single case historyJOURNAL OF CLINICAL NURSING, Issue 2004John Keady PhD This paper reports on a single case history taken from the ,Dementia Action Research and Education' project, a 15-month primary care intervention study that was undertaken in North Wales in the early part of 2000. The study sought to address the meaning, context and diversity of early intervention in dementia care and employed a community mental health nurse and a psychiatric social worker to undertake early and psychosocial interventions with older people with dementia (aged 75 years and over) and their families. The workers tape-recorded, documented and analysed their interventions with 27 older people with dementia and their families over the 15-month duration of the study. Clinical supervision was also undertaken during the intervention phase. One case history is presented in this paper to illustrate the work of the community mental health nurse and to identify areas of practice development. Greater role transparency, collaborative working and improvement in educational preparation for practice are called for. [source] The characteristics, qualities and skills of practice developersJOURNAL OF CLINICAL NURSING, Issue 3 2003Brendan Mccormack BSc, DPhil, PGCEA Summary ,,There is a growing interest in practice development as a systematic process for the development of quality patient care. ,,Whilst there is a range of accounts of practice development in the literature, little work has been undertaken to develop an understanding of the systems and processes involved and there is even less on the roles involved in practice development. ,,This paper explores in particular the characteristics, qualities and skills of practice developers, i.e. professionals who have formal responsibility for developing practice in organizations. ,,The paper represents part of a larger study exploring the conceptual basis of the term ,practice development'. ,,Data for this part of the project were collected through literature analysis, seven focus groups involving 60 practice developers and telephone interviews with 25 practising nurses with experience of working with practice developers. The data were analysed using cognitive mapping processes. ,,Four role functions are presented in the paper, as well as qualities and skills needed to operationalize the identified role functions. ,,A clear picture of the skills and qualities required by practice developers emerges from the data. [source] The experience of practice development: an exploratory telephone interview studyJOURNAL OF CLINICAL NURSING, Issue 1 2001Rob Garbett MSc , ,Practice development is a widely used term within British nursing. However, there is a lack of consistency and clarity in the way that the term is used. , ,A small-scale qualitative telephone interview study was therefore conceived to explore practitioners' views of practice development. , ,Qualitative telephone interviews were carried out with 26 nurses working in a range of settings and roles around the UK. Informants reported varying degrees of awareness of practice development roles and activities ranging from little awareness to being closely involved. , ,Most informants seemed to place more emphasis on issues of personal development and educational aspects of practice development than is found in the literature. , ,Practice development staff were seen as having a range of functions ranging from working with individual practitioners to the co-ordination of education and training within an organization. The credibility of practice development staff was closely related to their clinical experience and ability. [source] Cancer nursing practice development: understanding breathlessnessJOURNAL OF CLINICAL NURSING, Issue 1 2001Dip N, Meinir Krishnasamy MSc , ,This paper considers methodological and philosophical issues that arose during a multi-centre, randomized controlled trial of a new nursing intervention to manage breathlessness with patients with primary lung cancer. , ,Despite including a diverse range of instruments to measure the effects of the intervention, the uniqueness of individuals' experiences of breathlessness were often hidden by a requirement to frame the study within a reductionist research approach. , ,Evidence from the study suggests that breathlessness is only partly defined when understood and explored within a bio-medical framework, and that effective therapy can only be achieved once the nature and impact of breathlessness have been understood from the perspective of the individual experiencing it. , ,We conclude that to work therapeutically we need to know how patients interpret their illness and its resultant problems and that this demands methodological creativity. [source] The Edinburgh Principles with accompanying guidelines and recommendationsJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 3 2002H. Wilkinson Abstract A panel of experts attending a 3-day meeting held in Edinburgh, UK, in February 2001 was charged with producing a set of principles outlining the rights and needs of people with intellectual disability (ID) and dementia, and defining service practices which would enhance the supports available to them. The Edinburgh Principles, seven statements identifying a foundation for the design and support of services to people with ID affected by dementia, and their carers, were the outcome of this meeting. The accompanying guidelines and recommendations document provides an elaboration of the key points associated with the Principles and is structured toward a four-point approach: (1) adopting a workable philosophy of care; (2) adapting practices at the point of service delivery; (3) working out the coordination of diverse systems; and (4) promoting relevant research. It is expected that the Principles will be adopted by service organizations world-wide, and that the accompanying document will provide a useful and detailed baseline from which further discussions, research efforts and practice development can progress. [source] Creating the conditions for growth: a collaborative practice development programme for clinical nurse leadersJOURNAL OF NURSING MANAGEMENT, Issue 6 2010CHRISTINE A. BOOMER RGN, PG Cert. boomer c.a.& mccormack b. (2010) Journal of Nursing Management 18, 633,644 Creating the conditions for growth: a collaborative practice development programme for clinical nurse leaders Aim, To evaluate a 3-year practice development (PD) programme for clinical nurse leaders. Background, The development of effective leaders is a key objective to progress the modernization agenda. This programme aimed to develop the participants alongside development of the culture and context of care. Methods, Programme evaluation methodology to determine the ,worth' of the programme, inform the experience of the participation, effect on workplace cultures and determine effectiveness of the process used. Results, Created the conditions for growth under two broad themes: process outcomes demonstrating growth as leaders contributing to cultural shifts; and general outcomes demonstrating practice changes. Conclusions, Developing communities of reflective leaders are required to meet demands within contemporary healthcare. PD provides a model to develop leaders to achieve sustainable changes and transform practice. Implications for nursing management, Active collaboration and participation of managers is crucial in the facilitation of and sustainability of cultural change. Approaches adopted to develop and sustain the transformation of practice need to focus on developing the skills and attributes of leaders and managers as facilitators. [source] The manager's role in mobilizing and nurturing development: entrenched and engaged approaches to changeJOURNAL OF NURSING MANAGEMENT, Issue 3 2010BA RGN RHV HVL RNT PGCE, SUSAN M. CARR PhD carr s.m. & clarke c.l. (2010) Journal of Nursing Management 18, 332,338 The manager's role in mobilizing and nurturing development: entrenched and engaged approaches to change Aims, Drawing on findings from the evaluation of a Health Action Zone (HAZ), this paper explores the manager's role in promoting and nurturing learning. Background, Initiating practice development is a core function of the manager's role. Learning must be nurtured to reach beyond individual to organizational learning and address knowledge exchange as well as creation. In the United Kingdom, HAZs were established to reduce health inequalities. They embraced a variety of service delivery approaches, all with an emphasis on developing new ways of working and innovation. Methods, Qualitative interviews of the HAZ coordinators, performance manager and staff delivering services. Results, Two alternative ways of engagement and entrenchment to practice were identified to developing new ways of working and learning from experience. Conclusions, Development of sustainable and enduring structures which facilitate learning at both individual and organizational levels are key to utilization of knowledge and accumulation of learning. Implications for nursing management, When entrenched and engaged experiential learning in practice are pursued, the role of the manager as a catalyst needs to be highlighted. A tool is proposed to facilitate reflection and promote action plan development. This tool has potential general application, but our experience is that it makes a specific contribution to public health and primary care. [source] An appraisal of the use of secondment within a large teaching hospitalJOURNAL OF NURSING MANAGEMENT, Issue 6 2001BA(HONS), J. Hamilton RGN, M MED SCI Introduction, This study was undertaken in a large teaching hospital in Sheffield. It explores the use of secondment as a vehicle for practice, service and career development. Aim, To provide us with an understanding of the ways in which we utilize secondment opportunities, with a view to developing good practice guidelines that will help both the individual and the organization to maximize the potential in each secondment post. Method, A survey of nursing staff who had been on secondment during the previous year. Questionnaires were used to gather data from the senior nurse in each specialty directorate to develop an organizational (seconder) perspective and 20 secondees to provide an individual (secondee) perspective. Results, Nurses tended to be seconded from clinical roles into specialist clinical roles or non-clinical roles, predominantly in areas of research, audit, practice development and teaching. Seconded posts were new roles for individuals and the majority were relocated to new work environments. Secondment was overwhelmingly seen as an opportunity, allowing individuals to develop new skills and knowledge, progress their career and gain a broader strategic perspective. However, there were a number of barriers to progress: lack of role definition for the organization and the individual; uncertainty about the future; falsely raised hopes that secondments would be extended; uncertainty about status; and difficulties adjusting to a new environment and culture within unrealistically short timeframes. Conclusions, Secondment use has become widespread throughout the National Health Service (NHS) and is a very positive and popular vehicle for staff and service development. The potential benefits are high but must be offset against the risks. This paper introduces an organizational risk assessment matrix which can be used to inform the development of effective secondment ventures. [source] Practice development: a concept analysisJOURNAL OF NURSING MANAGEMENT, Issue 6 2000BSc (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] Guiding practice development using the Tidal CommitmentsJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2006N. BROOKES rn msc(a) phdcpmhn(c) The Tidal Model of Mental Health Recovery has contributed to the transformation of nursing practice at the Royal Ottawa Hospital (ROH), a psychiatric and mental health facility in Ontario, Canada. Ten commitments affirm the core values of the Tidal Model. These commitments guide person-centred, collaborative, strength-based practice and they facilitate Tidal teaching. In this paper we illustrate fidelity to the values, principles and processes of the model and the commitments while implementing the model. We share how some of the commitments are realized in our Tidal teaching and provide examples of successes and challenges. [source] Best practice from admission to discharge in acute inpatient care: considerations and standards from a whole system perspectiveJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 6 2005A. JONES phd bn (hons) rmn Effective mental health care and promotion involves numerous agencies and individuals. Hence, practice development for people with acute mental health needs requires a systemic (or whole system) perspective. Whilst a policy imperative, this is unfamiliar practice for many health and social care workers. In a previous paper published within this journal, the authors argued that admission to acute inpatient care may sometimes be occasioned by the need to contain worker anxiety within the whole system, rather than being clinically justified or necessary. In this paper the authors seek to follow up this premise with proposals for purposeful admission and standards to assure the quality throughout the patient journey, into and out of acute inpatient wards. [source] Training in cognitive behavioural interventions on acute psychiatric inpatient wardsJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2005E. McCANN phd msc rmn dip psi pgdip (academic practice) There has been a drive towards addressing the types of care and therapeutic interventions available to people with serious mental illness, which is reflected in the latest government mental health policy initiatives. Recent evidence strongly supports the implementation of psychological and social interventions for people with psychosis, and in particular the use of cognitive behavioural techniques. Until now, the main focus has been on people living in the community. This study examines the delivery of psychosocial interventions training to qualified psychiatric nurses and unqualified staff on seven acute psychiatric admission wards in London, UK. The approach had the strength of on-site delivery, follow-up role modelling of the interventions and clinical supervision. Despite this, in some cases the training was less successful, mainly because of staffing and leadership weaknesses. The impact of training in these methods and the implications for mental health education and practice development are discussed. [source] Caring for people in the ,virtual ward': the practical ramifications for acute nursing workJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2003M. DEACON, ba (hons) m.phil rmn srn enb(810) This paper discusses an aspect of data analysis arising from an ethnographic study of acute mental health nursing conducted in an inner city psychiatric unit. The data were collected in the form of field notes. These were made during and following episodes of participant observation on one acute ward and on a psychiatric intensive care unit over a period of 20 months. Acute wards have been subject to continuing criticism as both sites of care and treatment for mentally ill people and of nursing work. However, the practical operations of this social world remain largely unexamined. It is argued that without this understanding, mundane work methods will always be regarded as an impediment to work that is regarded as ,therapeutic' and therefore, of importance. The focus will be on phenomena named the ,virtual ward'. The research has demonstrated that the boundaries of nurses' responsibility reach far beyond the ward's spatial environment, both physically and communicatively. The complexity of the work that takes place within the virtual ward and the skills required for its successful completion are taken for granted, but are also a practical source of frustration. Anonymized examples from the practice site studied are used to illuminate the discussion. Working within the virtual ward is part of the messy reality of nurses' work. It is argued that understanding and respecting this reality is necessary if we are to be seriously and consistently ambitious about practice development. [source] Reflective practice and its role in mental health nurses' practice development: a year-long studyJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2000I. W. Graham PhD MED MSC BSC RN RMN The study reported in this paper lasted over a year, and identifies a conceptual framework of nursing practice based upon a relationship-building process. It also identifies six characteristics of nursing roles inherent within the practice of mental health nurses on a Nursing Development Unit. The paper presents a structure and process of reflection for nursing practice as illustrated by the work of a group of nurses working in a NDU. The purpose of the study was to help them better understand their work with patients. The findings from the study are used to explore how the nurses described and implemented individualized, patient-focused care. This care was based upon the ability of the nurse to communicate well and to build a relationship with a patient, bound within a context of change. [source] Evaluating evidence-based practice within critical careNURSING IN CRITICAL CARE, Issue 3 2008Helen O'Neal Abstract Background and Aims:, Between 2002-2005 the Trust undertook an action research project to evaluate a corporate practice development strategy. During this period clinicians became practitioner-researchers utilising a variety of methods to evaluate the influence of practice development. One aspect of this focused upon evaluation of evidence based guidelines. This article concentrates upon this process and the learning from this within critical care. Method:, Within critical care it was recognised that the standard of guidelines and protocols varied in terms of the amount of evidence used to underpin decision making. A group was set up to evaluate and appraise these using a structured format such as the Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument. Findings:, The initial evaluation (cycle 1) highlighted learning associated with the process of using the instrument within critical care, as well as where the quality of the guidelines could be improved. The second cycle of evaluation demonstrated that implementation of the action plans as a consequence of cycle 1 resulted in an improvement in the quality of the guidelines. It also resulted in streamlining the process of undertaking guideline appraisal across a Trust. Discussion and Conclusions:, Action resulting from analysis of the findings of cycle 1 led to a cultural change in which the structure of a tool such as the AGREE instrument could be beneficial in the development of future guidelines. This has been sustained both within critical care and Trust wide with various initiatives such as the establishment of critical care multidisciplinary guideline development groups and a Trust wide electronic library management system. [source] The use of physical restraint in critical careNURSING IN CRITICAL CARE, Issue 1 2007Karen Hine Abstract Critically ill patients are at high risk for the development of delirium and agitation, resulting in non-compliance with life-saving treatment. The use of physical restraint appears to be a useful and simple solution to prevent this treatment interference. In reality, restraint is a complex topic, encompassing physical, psychological, legal and ethical issues. This article briefly discusses the incidence of delirium and agitation in critically ill patients and examines in detail the method of physical restraint to manage treatment interference. The historical background of physical restraint is discussed and the prevalence of its use in critical care units across the world examined. Studies into the use of physical restraint are analysed, and in particular the physical effects on patients discussed. The use of physical restraint raises many legal, ethical and moral questions for all health care professionals; therefore, this study aims to address these questions. This article concludes by emphasizing areas of future practice development in intensive care units throughout the UK. [source] Developing best practice in critical care nursing: knowledge, evidence and practiceNURSING IN CRITICAL CARE, Issue 3 2003Paul Fulbrook Summary ,Because the current drive towards evidence-based critical care nursing practice is based firmly within the positivist paradigm, experimentally derived research tends to be regarded as ,high level' evidence, whereas other forms of evidence, for example qualitative research or personal knowing, carry less weight ,This poses something of a problem for nursing, as the type of knowledge nurses use most in their practice is often at the so-called ,soft' end of science. Thus, the ,Catch 22' situation is that the evidence base for nursing practice is considered to be weak ,Furthermore, it is argued in this paper that there are several forms of nursing knowledge, which critical care nurses employ, that are difficult to articulate ,The way forward requires a pragmatic approach to evidence, in which all forms of knowledge are considered equal in abstract but are assigned value according to the context of a particular situation ,It is proposed that this can be achieved by adopting an approach to nursing in which practice development is the driving force for change [source] | ||||||||||