Nursing practice

Participants' perspectives of a multi-component, group-based weight loss programme supplement for cardiac rehabilitation: A qualitative study Addressing overweight and obesity in people with cardiovascular risk factors is an important aspect of cardiac rehabilitation, but minimal implementation of targeted strategies has occurred. The aim of this study was to describe participants' perspectives of a multi-component, group-based weight loss supplement to cardiac rehabilitation programmes. Four focus groups of participants completing the intervention (n = 16) and maintenance phases (n = 19) of the Healthy Eating and Exercise Lifestyle Program (HEELP) were conducted. Interviews were transcribed and thematically analyzed using an inductive process. The overall theme of participants' responses was that HEELP helped them reprogramme their lifestyle behaviours to achieve weight loss. The programme was unique compared with other weight loss programmes because it was delivered and developed by familiar and expert health professionals who tailored the programme to participants' health status. Themes included the process of recognizing and deciding to make a commitment to managing their weight problem and feeling supported by the group and the staff to do this. Participants valued the group-based structure and the

The aim of this study was to explore the motivations of student nurses enrolled in nursing courses across a variety of Pacific Island countries. The image of nursing, the desire to help others, family and friends in the profession, personal experience, security, travel opportunities and flexibility have all been identified as motivators for people to enter nursing. To date, what motivates students in Pacific Island countries to enrol in a nursing course has not been investigated. An exploratory qualitative approach using focus group interviews with 152 nursing students was undertaken. Data were analysed using thematic content analysis, revealing four themes: (i) helping others; (ii) 'making a difference for my people'; (iii) following in the footsteps of others; and (iv) financial and professional gain. In a time of health and nursing workforce shortages, developing a deeper understanding of what drives people can be used to improve recruitment strategies in the future.

A structured telephonic counselling to promote the exclusive breastfeeding of healthy babies aged zero to six months: A pilot study This pilot study aimed to test the effectiveness of a structured telephonic counselling (STC) on exclusive breastfeeding (EB) on healthy babies. The study was carried out on 114 primiparous women from February to March 2009. After randomization, women were divided into two groups: 55 receiving STC and 59 receiving conventional counselling. At 1, 3 and 5 months after delivery, a nurse specialist evaluated the EB rates, the influence of mother's educational level and employment status on EB. Breastfeeding rates in STC were higher compared to conventional counselling (P < 0.01); resuming work was not an EB discouraging variable as 74.5% women in the STC resumed work vs. 54.2% of the conventional counselling. Breastfeeding promotion should start during pregnancy, advising women about benefits for the child in receiving human milk. STC should be used to improve EB in primiparous women.

Chronic illness causes the majority of disease burden and health costs in developed countries; however, this could be substantially reduced by optimal patient self-management. This study examined the levels of self-management in patients (n = 300) with chronic illness (chronic heart failure, chronic respiratory disease, Parkinson's disease and chronic schizophrenia) of moderate severity who had experienced an illness exacerbation in the last month. Patient's perceptions of self-efficacy in relation to their self-management and their sense of coherence were also assessed at baseline and 1 month later. No changes occurred in self-perceptions or self-management from baseline to follow-up. Patients at risk of poor self-management included people with low self-efficacy, poor sense of coherence, older age and a primary diagnosis of chronic schizophrenia. As self-efficacy is the only predictor known to be amenable to intervention, self-efficacy enhancing support should be promoted.

Older patients are vulnerable to adverse hospital events related to frailty. SPICES, a common screening protocol to identify risk factors in older patients, alerts nurses to initiate care plans to reduce the probability of patient harm. However, there is little published validating the association between SPICES and measures of frailty and adverse outcomes. This paper used data from a prospective cohort study on frailty among 174 older adult inpatients to validate SPICES. Almost all patients met one or more SPICES criteria. The sum of SPICES was significantly correlated with age and other well-validated assessments for vulnerability, comorbid conditions, and depression. Individuals meeting two or more SPICES criteria had a risk of adverse hospital events three times greater than individuals with either no or one criterion. Results suggest that as a screening tool used within 24 hours of admission, SPICES is both valid and predictive of adverse events.

Case management was initiated in the 1970s to reduce care discontinuity. A literature review focused on end-of-life (EOL) case management identified 17 research articles, with content analysis revealing two themes: (a) seeking to determine or establish the value of EOL case management and (b) identifying ways to improve EOL case management. The evidence, although limited, suggests that EOL case management is helpful to dying individuals and their families. Research is needed to more clearly illustrate its usefulness or outcomes and the extent of need for it and actual availability. Among other benefits, EOL case management may help reduce hospital utilization, a major concern with the high cost of hospital-based care and the increased desire for home-based EOL care.

This study examined Chinese fathers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; feelings about their partners&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; delivery and views on their presence during labour and birth. A questionnaire survey was conducted with 403 fathers whose partners gave birth in one provincial hospital in China. Data were analysed by descriptive statistics, χ(2)-test and content analysis. The results indicated that more than 80% of fathers experienced feelings of pride related to fatherhood and of love towards their partners and newborns. Significant differences in fathers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; feelings were found between subgroups with regard to age, education, employment, presence in the delivery room, method of birth and whether preparatory visits had been made to the hospital. The majority who answered an open-ended question on the meaning of fathers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; presence in the delivery room held a positive attitude towards fathers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; presence at labour and birth, as their presence could empower their partners and provide psychological support. This study indicates fathers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; presence at delivery and birth is important and that younger fathers need more support. It also provides evidence for clinical practice and future interventions to improve fathers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; psychological health and experiences.

Background: The diagnosis of pain documented in the nursing care process still needs to be evaluated. The reason is because there is still diversity in formulating the problem due to diverse nursing education, nurse knowledge, and even differences in reference standards used. Purpose: This study aimed to find out the application of diagnoses of nanda, nic, noc in improving the quality of nursing documentation.Method: This research method uses research design using descriptive analytics. The population in this study were 150 nurses in the inpatient hospital room of H.L Manambai Abdulkadir. The study sample was 73 nurses. The variable of this study is the application of diagnoses nanda, nic, noc in improving the quality of nursing documentation. Research instruments using questionnaires and statistical tests using frequency distribution.Results: The results show that the majority of nurse respondents had a female sex of 73%, and male sex numbered 27%. Based on the results of research ...

Neonatal intensive care unit (NICU) nurses are often faced with complex clinical and ethical problems. Little is known about the role of the NICU nurse in ethical decision-making, or processes that inform decision-making in this setting. The purpose of this study was to explore and describe nurses' perceptions of their role as patient advocate, clinical situations that cause them concern and the extent of their involvement in ethical decision-making. A combined quantitative and qualitative research design was used. A questionnaire was administered to nurses working in the NICU of the sole perinatal ter-Neonatal intensive care decision-making 109 tiary referral centre of Western Australia, Australia. Findings showed that NICU nurses saw their role in ethical decisionmaking primarily as advocating for the best interests of the infant and family, that they used clinical knowledge and experience to guide ethical decision-making, they were able to clearly articulate ethical problems and respond to them according to the clinical scenario and, while being primarily assertive in presenting their views, some nurses took a more passive approach. These findings support the need for development of a multidisciplinary model for ethical decisionmaking, where the view of all team members are considered.

A correlational design was used to examine nursing staff attitudes and subjective norms manifested in intended and actual care of drug users based on the Theory of Reasoned Action. One hundred and thirty-five nursing staff from three central Israeli hospitals completed a questionnaire examining theory-based variables as well as sociodemographic and professional characteristics. Most respondents reported a high to very high level of actual or intended care of drug users. Nurses&#39; stronger intentions to provide quality care to drug users were associated with more positive attitudes. Nursing staff members had moderately negative attitudes towards drug users. Nurses were found to hold negative stereotypes of drug addict patients and most considered the management of this group difficult. Positive attitudes towards drug users, perceived expectations of others and perceived correctness of the behaviour are important in their effect on the intention of nurses to provide high-quality car...

This study described the impact of adopting person-centred care approach for people with Alzheimer&#39;s disease on professional caregivers&#39; burden. The participants were subjected to a 4-week structured training programme about person-centred care. The programme&#39;s effectiveness was proven by using the Global Behavior Scale. Then a qualitative descriptive phenomenological approach was used to explore the impact of applying this programme on professional caregivers&#39; burden. Data were collected from a sample of 10 professional caregivers using semi-structured interviews. A total of three themes were identified: acceptance of disease-related behaviours of people with Alzheimer&#39;s, therapeutic understanding of people with Alzheimer&#39;s feelings (empathy) and enhanced caregivers&#39; adaptation to people with Alzheimer&#39;s demands (resiliency). Findings suggested that adopting person-centred care approach for people with Alzheimer&#39;s disease reduces professional car...

Migrant farmworkers represent one of the most marginalized and underserved populations in the United States. Acculturation theory cannot be easily mapped onto the transnational experience of migrant farmworkers, who navigate multiple physical and cultural spaces yearly, and who are not recognized by the state they constitute, &quot;the Citizen&apos;s Other&quot; (Kerber, 2009). This paper utilizes narrative analysis of a case study to illustrate, through the relationship of the narrator to migrant farmworkers and years of participant observation by the coauthors, how isolation from family and community, as well as invisibility within institutions, affect the health and well-being of migrant farmworkers in southeastern Georgia. Invisibility of farmworkers within institutions, such as health care, the educational system, social services, domestic violence shelters, and churches contribute to illness among farmworkers. The dominant American discourse surrounding immigration policy addr...

Nursing informatics serves global health care with information processing and communication functions like staff development and quality patient care services. The incorporation of computers into nursing in many developing countries though essential, has been on a decline growth. This qualitative study examined personnel and organizational factors that affect nursing informatics. A qualitative descriptive study design was employed. Respondents were registered nurses selected from the various health system levels. A total of 18 in-depth interviews were done. Interview data were analysed by using a thematic approach of qualitative analysis.Both senior and junior nursing staff had a fair knowledge of computers and some basic Microsoft applications. They both appreciated the need for immense incorporation of computers into Ghanaian nursing care although lacked organizational support. Rank, gender and age of respondents played immense role in their perception of importance computer skill...

Electronic health records are expected to improve the quality of care provided to hospitalized patients. For nurses, use of electronic documentation sources becomes highly relevant because this is where they obtain the majority of necessary patient information. An integrative review of the literature examined the relationship between electronic nursing documentation and the quality of care provided to hospitalized patients. Donabedian&#39;s quality framework was used to organize empirical literature for review. To date, the use of electronic nursing documentation to improve patient outcomes remains unclear. Future research should investigate the day-to-day interactions between nurses and electronic nursing documentation for the provision of quality care to hospitalized patients. The majority of U.S. hospital care units currently use paper-based nursing documentation to exchange patient information for quality care. However, by 2014, all U.S. hospitals are expected to use electronic ...

This study was conducted in one multicultural dementia day-care centre over a period of 18 months. It introduced a gentle hand treatment for clients using three essential oils. The study evolved out of the process of action research where the family carers and day-care staff participated with the researchers to choose, design, develop and evaluate a hand treatment programme. Data was collected through in-depth interviews pre-and post-treatment, focus group discussions, client observation logbooks and a disability scale. The findings indicate a positive strengthening of the relationship between the person with dementia and their family carer, and an improvement in feelings of health and well-being for both. The specific improvements for clients include increased alertness, self-hygiene, contentment, initiation of toileting, sleeping at night and reduced levels of agitation, withdrawal and wandering. Family carers have reported less distress, improved sleeping patterns and feelings of calm. They also found the treatment useful in helping them manage the difficult behaviours exhibited by their relative with dementia. The benefits of this treatment for nursing practice are that it is safe, effective and easily administered by staff in any setting. a multicultural dementia day-care service in the south-Technology,

Grounded theory is a popular research methodology that is evolving to account for a range of ontological and epistemological underpinnings. Constructivist grounded theory has its foundations in relativism and an appreciation of the multiple truths and realities of subjectivism. Undertaking a constructivist inquiry requires the adoption of a position of mutuality between researcher and participant in the research process, which necessitates a rethinking of the grounded theorists' traditional role of objective observer. Key issues for constructivist grounded theorists to consider in designing their research studies are discussed in relation to developing a partnership with participants that enables a mutual construction of meaning during interviews and a meaningful reconstruction of their stories into a grounded theory model.

This paper reports on workplace violence, self-reported as part of a survey among members of the Queensland Nurses&#x27; Union (QNU) in October 2001. The aim of the overall study was to ascertain how nurses perceived their work and their working conditions and to use the ...

This paper explores the challenging and contentious issue of abortion and its ethical, legal and political significance regarding public health. It is intended as an educational guide for health-care professionals. A comprehensive search strategy of international health, law and political source materials was undertaken in order to benchmark from international approaches to abortion. Test cases illustrate the application of legislation, ethical, political and cultural issues surrounding abortion. Abortion is a complex contemporary issue where balancing the well-being of both the mother and the unborn has prompted considerable international discourse. The right to life of the woman and the unborn continues to lie in tension. Ambiguity surrounds the concept of personhood, and the inception of human life prevails across many International jurisdictions. Health-care professionals must be well informed in order to respond safely and appropriately to a diverse range of clinical scenarios ...

The concept of health contains aspects of social and mental well-being and not just the absence of disease. The concept of well-being is sometimes used interchangeably with the term happiness, although focus has been on other aspects as well.

A three-stage process is being undertaken to investigate the fundamentals of care. Stage One (reported here) involves the use of a met a-narrative review methodology to undertake a thematic analysis, categorization and synthesis of selected contents extracted from seminal texts relating to nursing practice. Stage Two will involve a search for evidence to inform the fundamentals of care and a refinement of the review method. Stage Three will extend the reviews of the elements defined as fundamentals of care. This introductory paper covers the following aspects: the conceptual basis upon which nursing care is delivered; how the fundamentals of care have been defined in the literature and in practice; an argument that physiological aspects of care, self-care elements and aspects of the environment of care are central to the conceptual refinement of the term fundamentals of care; and that efforts to systematize such information will enhance overall care delivery through improvements in ...

This research is the second part of a more comprehensive study. The purpose of this part of the study is to examines the relationship between the level of moral distress, work motivation, and job satisfaction of medical-surgical nurses in Hail Saudi Arabia. This study used a descriptive-correlation research design using the combination of three questionnaires (Moral Distress Questionnaire, Multidimensional Work Motivation Scale, and Nurses Job Satisfaction Questionnaire) through an online survey. There are 274 respondents in this study. The statistical tests used are mean, standard deviation, and Pearson-r. Results include about the relationship between moral distress and work motivation Pearson-r scored r=0.07; p=0.27; regarding the relationship between moral distress and job satisfaction Pearson-r scored r=-0.35; p=&lt;0.001; concerning the relationship between work motivation and job satisfaction, Pearson-r scored r=0.05; p=0.42. The researchers conclude that moral distress is mi...

Nurse managers who can observe their own behaviour and its effects on employees can adjust to a better leadership style. The intention of this study was to explore nurses' and supervisors' perceptions of nurse managers' leadership styles. Open-ended interviews were conducted with 11 nurses and 10 superiors. The data were analysed by content analysis. In the study, six leadership styles were identified: visionary, coaching, affiliate, democratic, commanding, and isolating. Job satisfaction and commitment as well as operation and development work, cooperation, and organizational climate in the work unit were the factors, affected by leadership styles. The nurse managers should consider their leadership style from the point of view of employees, situation factors, and goals of the organization. Leadership styles where employees are seen in a participatory role have become more common.

It is the intention of this literature review to present suggestions for nursing practice with reference to the care of the dually diagnosed. Nursing care of the dually diagnosed client is complex. Clinicians from both drug and alcohol services and mental health services have long recognized that neither service area provides adequate clinical care to those clients who have a dual diagnosis of substance abuse and mental illness. It is now &gt; 10 years since a ground-breaking Australian study recognized this. To ascertain whether there has been improvement in the service management of clients who have a dual diagnosis, and to determine the best practice interventions in the area of mental health nursing, we undertook a review of the literature. The databases CINAHL, MEDLINE, PsycARTICLES and PsychINFO were searched and 185 articles met the inclusion criteria. From this review, it seems that gaps still remain in the provision of services and that mental health nurses might be best pl...

The aim of this study is to describe patients' satisfaction with the new role of advanced practice nurses (APNs) in Swedish primary care. A questionnaire pertaining to patient satisfaction with the care offered by APNs was sent to respondents. Descriptive statistics, a chi-squared test and manifest qualitative content analysis were used during analysis. Although the results show an overall high level of patient satisfaction as regards APN-led care, those patients informed of the APN role prior to a consultation were significantly more satisfied. Respondents' comments indicate that professional treatment and competence are characteristic of the care offered by APNs and also relate the concepts of increased availability of and continuity in health care to the APN role. In order to guarantee the positive development of the APN role in Sweden, continued research is needed from patient, organizational and interprofessional perspectives, including intervention studies of cost effectiveness and the quality of care.

Nurses' computer literacy and attitudes towards the use of computers in health care This descriptive and cross-sectional study was designed to address nurses' computer literacy and attitudes towards the use of computers in health care and to determine the correlation between these two variables. This study was conducted with the participation of 688 nurses who worked at two university-affiliated hospitals. These nurses were chosen using a stratified random sampling method. The data were collected using the Multicomponent Assessment of Computer Literacy and the Pretest for Attitudes Towards Computers in Healthcare Assessment Scale v. 2. The nurses, in general, had positive attitudes towards computers, and their computer literacy was good. Computer literacy in general had significant positive correlations with individual elements of computer competency and with attitudes towards computers. If the computer is to be an effective and beneficial part of the health-care system, it is necessary to help nurses improve their computer competency.

Neonatal intensive care unit (NICU) nurses are often faced with complex clinical and ethical problems. Little is known about the role of the NICU nurse in ethical decision-making, or processes that inform decision-making in this setting. The purpose of this study was to explore and describe nurses' perceptions of their role as patient advocate, clinical situations that cause them concern and the extent of their involvement in ethical decision-making. A combined quantitative and qualitative research design was used. A questionnaire was administered to nurses working in the NICU of the sole perinatal ter-Neonatal intensive care decision-making 109 tiary referral centre of Western Australia, Australia. Findings showed that NICU nurses saw their role in ethical decisionmaking primarily as advocating for the best interests of the infant and family, that they used clinical knowledge and experience to guide ethical decision-making, they were able to clearly articulate ethical problems and respond to them according to the clinical scenario and, while being primarily assertive in presenting their views, some nurses took a more passive approach. These findings support the need for development of a multidisciplinary model for ethical decisionmaking, where the view of all team members are considered.

A case study of six wards in two hospitals was undertaken to describe the structures, processes and perceptions of outcomes of bedside handover in nursing. A total of 532 bedside handovers were observed and 34 interviews with nurses conducted. Important structural elements related to the staff, patients, the handover sheet and the bedside chart. A number of processes prior to, during, and after the handover were implemented. They included processes for managing patients and their visitors, sensitive information, and the flow of communication for variable shift starting times. Other key processes identified were the implementation of a safety scan and medication check. The situation, background, assessment, recommendations (SBAR) approach was used only in specific circumstances.

ABSTRACT:
Historically, nursing care plans were administered in academic field to teach a process that nursing students can
use it to identify and define a patient-centred problem. Nursing process has evolved to a five step process which
includes assessment, diagnosis, planning, implementation and evaluation. But it has been observed that nurses
are not following all the steps of nursing process because of one or other reasons like inadequate knowledge
regarding nursing process, heavy workload, staff shortage, lots of paper work, poor quality of professional
education, lack of motivation and unplanned early discharge. Nurses are not developing care plans on the basis
of patient’s needs, they are just providing care which has been prescribed by the doctors and not focusing on
nursing care plan. Whereas, it is an essential document to maintain record. The impetus of this review is to
improve the utilization of nursing care plan by making it less time consuming, less paper work and reduces the
workload of nurses. So, nurses can change their attitude and start utilization of nursing care plan for providing
better care to the patient. This concise nursing care plan (CNCP) includes all the steps of nursing care plan and
reduces more writing work making it easy to follow.
KEYWORDS: Nursing care plan, Nursing Process.

Objectives. The objective of this study was to describe first-time mothers' experiences and reflections of their first birth. Study Design. This study is a part of a larger study which was carried out in southwestern Sweden in 2008. A qualitative method with content analysis was chosen for this study. The unit of data was 14 written narratives from the first-time mothers. Results. The theme "To be empowered increases first-time mothers' chances for a positive birth experience" crossed over into all the three categories: "To trust the body and to face the pain, " "Interaction between body and mind in giving birth," and "Consistency of support. " Conclusion. In order to feel confident in their first childbirth, the women wanted to be confirmed and seen as unique individuals by the professionals and their partner. If professionals responded to the individual woman's needs of support, the woman more often had a positive birth experience, even if the birth was protracted or with medical complications.

Jefferies D, Johnson M, Griffiths R. International Journal of Nursing Practice 2010; 16: 112–124 A meta-study of the essentials of quality nursing documentationThe aim of this study was to synthesize all relevant information about nursing documentation and present the essential aspects of quality nursing documentation. Literature searches, limited to the English language, were conducted on both CINAHL (1982 to week 3, April 2008) and MEDLINE (1996 to April 2008) using the following search terms: attitude, audit, care, culture, documentation, guideline health, in service, legal, liability, medical, nurses, nursing, organizational, patient, personnel, planning practice, quality, records, research and training. One hundred and seventy-one papers were reviewed for their relevance to the clinical question. Twenty-eight articles were read by two researchers. Data informing the clinical question were extracted and categorized into key concepts by an analysis of similarities. The seven major themes (essentials) of quality nursing documentation were identified. This paper has reviewed contemporary literature, research evidence and local policies to identify the seven essential components of quality nursing documentation. Some of the barriers or more controversial aspects of the final policy are described.

Electronic health records are expected to improve the quality of care provided to hospitalized patients. For nurses, use of electronic documentation sources becomes highly relevant because this is where they obtain the majority of necessary patient information. Methods: An integrative review of the literature examined the relationship between electronic nursing documentation and the quality of care provided to hospitalized patients. Donabedian's quality framework was used to organize empirical literature for review. Results: To date, the use of electronic nursing documentation to improve patient outcomes remains unclear. Conclusions and Implications: Future research should investigate the daytoday interactions between nurses and electronic nursing documentation for the provision of quality care to hospitalized patients.

Aims: To determine the factors contributing to managerial competence of first‐line nurse managers. Background: Understanding factors affecting managerial competence of nurse managers remains important to increase the performance of organizations; however, there is sparse research examining factors that influence managerial competence of first‐line nurse managers. Design: Systematic review. Data sources: The search strategy was conducted from April to July 2017 that included 6 electronic databases: Science Direct, PROQUEST Dissertations and Theses, MEDLINE, CINAHL, EMBASE, and Google Scholar for the years 2000 to 2017 with full text in English. Quantitative and qualitative research papers that examined relationships among managerial competence and antecedent factors were included. Review methods: Quality assessment, data extractions, and analysis were completed on all included studies. Content analysis was used to categorize factors into themes. Results: Eighteen influencing factors ...

This study aimed to explore complexities in nursing documentation and related factors. Nursing documentation has been one of the most important functions of nurses since the time of Florence Nightingale because it serves multiple and diverse purposes. Current health-care systems require that documentation ensures continuity of care, furnishes legal evidence of the process of care and supports evaluation of quality of patient care. However, nursing documentation has not served such objectives because of its complexities. This study explores nursing documentation complexities and related factors through both qualitative and quantitative methodologies. The study used multiple methods of inquiry: in-depth interviewing; participant observation; nominal group processing; focus group meetings; time and motion study of nursing activities; and auditing of completeness of nursing documentation. Complexities in nursing documentation include three aspects: disruption, incompleteness and inappropriate charting. Related factors that influenced documentation comprised: limited nurses' competence, motivation and confidence; ineffective nursing procedures; and inadequate nursing audit, supervision and staff development. These findings suggest that complexities in nursing documentation require extensive resolution and implicitly dictate strategies for nurse managers and nurses to take part in solving these complicated obstacles.